Provider Demographics
NPI:1790022085
Name:CURTIS, JOLENE F (LCSW)
Entity Type:Individual
Prefix:
First Name:JOLENE
Middle Name:F
Last Name:CURTIS
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 1:2225 GATEWAY DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:SYCAMORE
Mailing Address - State:IL
Mailing Address - Zip Code:60178-3139
Mailing Address - Country:US
Mailing Address - Phone:815-764-1200
Mailing Address - Fax:
Practice Address - Street 1:2225 GATEWAY DR
Practice Address - Street 2:SUITE B
Practice Address - City:SYCAMORE
Practice Address - State:IL
Practice Address - Zip Code:60178-3139
Practice Address - Country:US
Practice Address - Phone:815-764-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0154201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical