Provider Demographics
NPI:1205944451
Name:FRANCIS-HOHL, COLLETTE ANGEL (LCSW)
Entity type:Individual
Prefix:MRS
First Name:COLLETTE
Middle Name:ANGEL
Last Name:FRANCIS-HOHL
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 1:24125 CROPLAND DRIVE
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544
Mailing Address - Country:US
Mailing Address - Phone:815-603-2119
Mailing Address - Fax:
Practice Address - Street 1:23819 W MILL STREET
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544
Practice Address - Country:US
Practice Address - Phone:815-603-2119
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149007889104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL09932349OtherBLUE CROSS BLUE SHIELD
IL09932349OtherBLUE CROSS BLUE SHIELD