Provider Demographics
NPI:1932318722
Name:ARNESON, KATHLEEN GRACE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:GRACE
Last Name:ARNESON
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 1:721 HINMAN AVE
Mailing Address - Street 2:#2E
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-2585
Mailing Address - Country:US
Mailing Address - Phone:847-866-8680
Mailing Address - Fax:
Practice Address - Street 1:4711 GOLF RD
Practice Address - Street 2:SUITE 700
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1224
Practice Address - Country:US
Practice Address - Phone:847-347-7346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical