Provider Demographics
NPI:1639980469
Name:STYCZEN, JORDAN LYNN (LSW MSW)
Entity type:Individual
Prefix:MRS
First Name:JORDAN
Middle Name:LYNN
Last Name:STYCZEN
Suffix:
Gender:F
Credentials:LSW MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 OAK CREEK DR APT 105
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:IL
Mailing Address - Zip Code:60090-6735
Mailing Address - Country:US
Mailing Address - Phone:224-518-5610
Mailing Address - Fax:
Practice Address - Street 1:31 N VIRGINIA ST
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-4125
Practice Address - Country:US
Practice Address - Phone:815-900-4554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-20
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.108663104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker