Provider Demographics
NPI:1821376187
Name:GIVEN, THERESE (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:THERESE
Middle Name:
Last Name:GIVEN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 SEWARD ST APT 1W
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-2168
Mailing Address - Country:US
Mailing Address - Phone:210-901-8130
Mailing Address - Fax:
Practice Address - Street 1:1603 ORRINGTON AVE STE 600
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-3860
Practice Address - Country:US
Practice Address - Phone:847-861-7899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-03
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker