Provider Demographics
NPI:1659895712
Name:CAREY, COLLEEN (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:COLLEEN
Middle Name:
Last Name:CAREY
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:MRS
Other - First Name:COLLEEN
Other - Middle Name:CAREY
Other - Last Name:SHINNERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:1529 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091-1652
Mailing Address - Country:US
Mailing Address - Phone:847-946-2428
Mailing Address - Fax:
Practice Address - Street 1:636 CHURCH ST STE 418
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-4580
Practice Address - Country:US
Practice Address - Phone:847-946-2428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-31
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490096811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical