Provider Demographics
NPI:1740612647
Name:PERRONE, DEANNA MARIA (LCSW)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:MARIA
Last Name:PERRONE
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 1:3755 E MAIN ST STE 165
Mailing Address - Street 2:
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-2409
Mailing Address - Country:US
Mailing Address - Phone:312-576-4445
Mailing Address - Fax:
Practice Address - Street 1:3755 E MAIN ST STE 165
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-2409
Practice Address - Country:US
Practice Address - Phone:312-576-4445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-01
Last Update Date:2023-03-23
Deactivation Date:2016-09-30
Deactivation Code:
Reactivation Date:2023-03-23
Provider Licenses
StateLicense IDTaxonomies
IL1490160101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical