Provider Demographics
NPI:1013609387
Name:SCRANTON, JAIME LYNN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JAIME
Middle Name:LYNN
Last Name:SCRANTON
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 1:1077 CHURCHILL DR
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-1451
Mailing Address - Country:US
Mailing Address - Phone:630-673-5634
Mailing Address - Fax:
Practice Address - Street 1:1077 CHURCHILL DR
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-1451
Practice Address - Country:US
Practice Address - Phone:630-673-5634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490137761041S0200X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool