Provider Demographics
NPI:1336411982
Name:HARDEN, JENELLE LOUISE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JENELLE
Middle Name:LOUISE
Last Name:HARDEN
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 1:7023 N MONON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646-1209
Mailing Address - Country:US
Mailing Address - Phone:773-918-5048
Mailing Address - Fax:
Practice Address - Street 1:7023 N MONON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-1209
Practice Address - Country:US
Practice Address - Phone:773-918-5048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-29
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
IL1490149821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical