Provider Demographics
NPI:1790320158
Name:EMILY HANNEMAN, LCSW PLLC
Entity Type:Organization
Organization Name:EMILY HANNEMAN, LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:HANNEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:312-650-9025
Mailing Address - Street 1:4809 N RAVENSWOOD AVE UNIT 319A
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-6648
Mailing Address - Country:US
Mailing Address - Phone:312-650-9025
Mailing Address - Fax:
Practice Address - Street 1:4809 N RAVENSWOOD AVE UNIT 319A
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-6648
Practice Address - Country:US
Practice Address - Phone:312-650-9025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-08
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty