Provider Demographics
NPI:1922347608
Name:BRODSKY, ESTHER S (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ESTHER
Middle Name:S
Last Name:BRODSKY
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 1:926 HAYES AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-1412
Mailing Address - Country:US
Mailing Address - Phone:708-848-0442
Mailing Address - Fax:
Practice Address - Street 1:1140 LAKE ST
Practice Address - Street 2:STE. 401
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1049
Practice Address - Country:US
Practice Address - Phone:708-848-0442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-31
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490115801041C0700X, 1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool