Provider Demographics
NPI:1396869269
Name:VASICH, MARIA V (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:V
Last Name:VASICH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:VASICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:1724 CLYDE DR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60565-2302
Mailing Address - Country:US
Mailing Address - Phone:630-527-8229
Mailing Address - Fax:
Practice Address - Street 1:1724 CLYDE DR
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60565-2302
Practice Address - Country:US
Practice Address - Phone:630-527-8229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041S0200X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical