Provider Demographics
NPI:1134908429
Name:DHAN, VINCENT (MSW, LSW, CADC)
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:
Last Name:DHAN
Suffix:
Gender:M
Credentials:MSW, LSW, CADC
Other - Prefix:
Other - First Name:VINCENT
Other - Middle Name:
Other - Last Name:DHAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1005 APPLE CT
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60505-1456
Mailing Address - Country:US
Mailing Address - Phone:630-386-5001
Mailing Address - Fax:
Practice Address - Street 1:1005 APPLE CT
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60505-1456
Practice Address - Country:US
Practice Address - Phone:630-386-5001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1501064901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical