Provider Demographics
NPI:1356080345
Name:BARON, KATHRYN (LCSW)
Entity type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:
Last Name:BARON
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 1:7652 MADISON ST UNIT 211
Mailing Address - Street 2:
Mailing Address - City:FOREST PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60130-3074
Mailing Address - Country:US
Mailing Address - Phone:630-247-4601
Mailing Address - Fax:
Practice Address - Street 1:1461 E 56TH ST APT 1W
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-6885
Practice Address - Country:US
Practice Address - Phone:708-320-1828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-31
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0184431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical