Provider Demographics
NPI:1669650636
Name:FEFER, ENID (LCSW)
Entity Type:Individual
Prefix:
First Name:ENID
Middle Name:
Last Name:FEFER
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 1:7061 N KEDZIE AVE
Mailing Address - Street 2:614
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-2846
Mailing Address - Country:US
Mailing Address - Phone:773-743-0038
Mailing Address - Fax:
Practice Address - Street 1:777 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-3240
Practice Address - Country:US
Practice Address - Phone:847-432-4981
Practice Address - Fax:847-432-7331
Is Sole Proprietor?:No
Enumeration Date:2008-02-01
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical