Provider Demographics
NPI:1609007277
Name:LARKIN, DOLORES (LCSW)
Entity Type:Individual
Prefix:
First Name:DOLORES
Middle Name:
Last Name:LARKIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1141 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60304-2209
Mailing Address - Country:US
Mailing Address - Phone:708-927-0990
Mailing Address - Fax:
Practice Address - Street 1:401 SOUTH LASALLE ST
Practice Address - Street 2:801 - CHICAGO PERSONAL GROWTH INSTITUTE
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-1057
Practice Address - Country:US
Practice Address - Phone:708-927-0990
Practice Address - Fax:773-826-1835
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-30
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149009735104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker