Provider Demographics
NPI:1972939791
Name:BYRNE, ANNE THERESE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:THERESE
Last Name:BYRNE
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 1:3139 N LINCOLN AVE
Mailing Address - Street 2:#209
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-3114
Mailing Address - Country:US
Mailing Address - Phone:312-519-3187
Mailing Address - Fax:
Practice Address - Street 1:3139 N LINCOLN AVE
Practice Address - Street 2:#209
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-3114
Practice Address - Country:US
Practice Address - Phone:312-519-3187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-25
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490103031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical