Provider Demographics
NPI:1891376646
Name:ARELLANO, KARLAN JON (LCSW)
Entity Type:Individual
Prefix:
First Name:KARLAN
Middle Name:JON
Last Name:ARELLANO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 E LINCOLNWAY UNIT M
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:IL
Mailing Address - Zip Code:61081-1761
Mailing Address - Country:US
Mailing Address - Phone:815-632-6200
Mailing Address - Fax:
Practice Address - Street 1:2901 E LINCOLNWAY UNIT M
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:IL
Practice Address - Zip Code:61081-1761
Practice Address - Country:US
Practice Address - Phone:815-632-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-14
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0269101041C0700X
IL150.105296104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker