Provider Demographics
NPI:1295087997
Name:COKER, EVELYN JOY (LCSW)
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:JOY
Last Name:COKER
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 1:6342 S KENWOOD AVE
Mailing Address - Street 2:APT 1
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60637-3767
Mailing Address - Country:US
Mailing Address - Phone:773-803-9587
Mailing Address - Fax:
Practice Address - Street 1:6342 S. KENWOOD AVE
Practice Address - Street 2:APT 1
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-3767
Practice Address - Country:US
Practice Address - Phone:773-803-9587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-05
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0147321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical