Provider Demographics
NPI:1669829537
Name:LARKIN, JANE (LCSW)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:LARKIN
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 1:5321 N LINCOLN AVE
Mailing Address - Street 2:4D
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-3988
Mailing Address - Country:US
Mailing Address - Phone:773-562-8201
Mailing Address - Fax:
Practice Address - Street 1:5321 N LINCOLN AVE
Practice Address - Street 2:4D
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-3988
Practice Address - Country:US
Practice Address - Phone:773-562-8201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-19
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490072821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical