Provider Demographics
NPI:1770678898
Name:GILBERG, LEANNE RAE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LEANNE
Middle Name:RAE
Last Name:GILBERG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LEANNE
Other - Middle Name:RAE
Other - Last Name:O'DONNELL-GILBERG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:25234 W. TOWPATH LANE
Mailing Address - Street 2:
Mailing Address - City:CHANNAHON
Mailing Address - State:IL
Mailing Address - Zip Code:60410-9322
Mailing Address - Country:US
Mailing Address - Phone:815-467-6651
Mailing Address - Fax:
Practice Address - Street 1:3077 W JEFFERSON ST
Practice Address - Street 2:SUITE 108
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-5262
Practice Address - Country:US
Practice Address - Phone:816-260-4020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILTYPE 73 CERTIFICATE1041S0200X
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical