Provider Demographics
NPI:1942567417
Name:ROLLINS, JATAUN J (LCSW)
Entity Type:Individual
Prefix:
First Name:JATAUN
Middle Name:J
Last Name:ROLLINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JATAUN
Other - Middle Name:
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 717
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60425-0717
Mailing Address - Country:US
Mailing Address - Phone:773-398-2298
Mailing Address - Fax:
Practice Address - Street 1:243 W 95TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60628-1375
Practice Address - Country:US
Practice Address - Phone:708-491-3303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-20
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490111601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical