Provider Demographics
NPI:1801379342
Name:MACIAS, LUZ MARIA (LCSW)
Entity Type:Individual
Prefix:
First Name:LUZ
Middle Name:MARIA
Last Name:MACIAS
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 1:3544 CUYLER AVE
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:IL
Mailing Address - Zip Code:60402-3804
Mailing Address - Country:US
Mailing Address - Phone:708-209-5248
Mailing Address - Fax:
Practice Address - Street 1:125 WINDSOR DR STE 111
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-4081
Practice Address - Country:US
Practice Address - Phone:847-916-7976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-11
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490057661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical