Provider Demographics
NPI:1609212802
Name:SWENINK, LUCAS BYRON (LCSW, CADC)
Entity Type:Individual
Prefix:MR
First Name:LUCAS
Middle Name:BYRON
Last Name:SWENINK
Suffix:
Gender:M
Credentials:LCSW, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4433 N RAVENSWOOD AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-7755
Mailing Address - Country:US
Mailing Address - Phone:312-834-5487
Mailing Address - Fax:773-944-1057
Practice Address - Street 1:4305 N LINCOLN AVE
Practice Address - Street 2:SUITE M
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-1711
Practice Address - Country:US
Practice Address - Phone:312-834-5487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-14
Last Update Date:2018-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0158981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical