Provider Demographics
NPI:1356916126
Name:DWYER, JAMEYLEE P (LCSW)
Entity type:Individual
Prefix:
First Name:JAMEYLEE
Middle Name:P
Last Name:DWYER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JAMEY
Other - Middle Name:P
Other - Last Name:DWYER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:6723 WEAVER RD STE 120
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61114-8021
Mailing Address - Country:US
Mailing Address - Phone:815-540-2959
Mailing Address - Fax:
Practice Address - Street 1:6723 WEAVER RD STE 120
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61114-8021
Practice Address - Country:US
Practice Address - Phone:815-540-2959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-24
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI12028-1231041C0700X
IL149.90303061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical