Provider Demographics
NPI:1396959276
Name:JANOSKY, KATHLEEN KREMER (LCSW)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:KREMER
Last Name:JANOSKY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:KATHLEEN
Other - Middle Name:KREMER
Other - Last Name:JANOSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3116 CLARENCE AVE
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:IL
Mailing Address - Zip Code:60402-3114
Mailing Address - Country:US
Mailing Address - Phone:708-795-0049
Mailing Address - Fax:
Practice Address - Street 1:1127 N OAKLEY BLVD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-3507
Practice Address - Country:US
Practice Address - Phone:312-770-2577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical