Provider Demographics
NPI:1639627813
Name:KOZIOL, WIOLETA (LCSW)
Entity Type:Individual
Prefix:
First Name:WIOLETA
Middle Name:
Last Name:KOZIOL
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 1:1777 W CRYSTAL LN
Mailing Address - Street 2:UNIT 201
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-5462
Mailing Address - Country:US
Mailing Address - Phone:773-372-5996
Mailing Address - Fax:
Practice Address - Street 1:2804 W BELMONT AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-5880
Practice Address - Country:US
Practice Address - Phone:773-372-5996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-15
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0175281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical