Provider Demographics
NPI:1639297641
Name:RICCARDI, GIANNINA G (LCSW)
Entity Type:Individual
Prefix:
First Name:GIANNINA
Middle Name:G
Last Name:RICCARDI
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 1:1445 N STATE PKWY
Mailing Address - Street 2:#2202
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-1565
Mailing Address - Country:US
Mailing Address - Phone:312-485-8714
Mailing Address - Fax:312-915-7645
Practice Address - Street 1:50 E WASHINGTON ST
Practice Address - Street 2:#301
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-2152
Practice Address - Country:US
Practice Address - Phone:312-337-5874
Practice Address - Fax:312-337-9243
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical