Provider Demographics
NPI:1023262508
Name:DEVRIES, FELICIA G (LCSW)
Entity type:Individual
Prefix:MS
First Name:FELICIA
Middle Name:G
Last Name:DEVRIES
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 1:5616 N KENMORE AVE
Mailing Address - Street 2:APT 3C
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-4606
Mailing Address - Country:US
Mailing Address - Phone:312-485-6160
Mailing Address - Fax:
Practice Address - Street 1:5616 N KENMORE AVE
Practice Address - Street 2:APT 3C
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60660-4606
Practice Address - Country:US
Practice Address - Phone:312-485-6160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-10
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490116251041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool