Provider Demographics
NPI:1952824492
Name:VILLALOBOS, LINDA KATHRYN (LCSW)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:KATHRYN
Last Name:VILLALOBOS
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 1:9033 S BELL AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-6419
Mailing Address - Country:US
Mailing Address - Phone:773-881-0315
Mailing Address - Fax:
Practice Address - Street 1:9033 S BELL AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-6419
Practice Address - Country:US
Practice Address - Phone:773-881-0315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0092321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical