Provider Demographics
NPI:1639289606
Name:HWANG, MEREDITH SORELLE (LCSW, MA)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:SORELLE
Last Name:HWANG
Suffix:
Gender:F
Credentials:LCSW, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 W NEWPORT AVE UNIT 3
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-1504
Mailing Address - Country:US
Mailing Address - Phone:773-398-9150
Mailing Address - Fax:
Practice Address - Street 1:1300 W BELMONT AVE STE 308
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-3241
Practice Address - Country:US
Practice Address - Phone:773-398-9150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149011781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical