Provider Demographics
NPI:1649349473
Name:WEST HOOPER, GAIL MAUREEN (LCSW)
Entity type:Individual
Prefix:MS
First Name:GAIL
Middle Name:MAUREEN
Last Name:WEST HOOPER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:GAIL
Other - Middle Name:MAUREEN
Other - Last Name:WEST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:707 W BROWN ST
Mailing Address - Street 2:
Mailing Address - City:WEST CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60185
Mailing Address - Country:US
Mailing Address - Phone:630-231-0267
Mailing Address - Fax:630-231-0357
Practice Address - Street 1:404 BOUGHTON ROAD
Practice Address - Street 2:B
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440
Practice Address - Country:US
Practice Address - Phone:630-759-1732
Practice Address - Fax:630-231-0357
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical