Provider Demographics
NPI:1942326657
Name:MCCOOL-HENDERSON, LORI ANNE (LCSW)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:ANNE
Last Name:MCCOOL-HENDERSON
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 1:1631 HUNTINGTON LN
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-2713
Mailing Address - Country:US
Mailing Address - Phone:847-868-4926
Mailing Address - Fax:
Practice Address - Street 1:1631 HUNTINGTON LN
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-2713
Practice Address - Country:US
Practice Address - Phone:847-868-4926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0038111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical