Provider Demographics
NPI:1649501669
Name:CANDEE, JUDITH G (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:G
Last Name:CANDEE
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 RAVINE RD
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3714
Mailing Address - Country:US
Mailing Address - Phone:630-655-2599
Mailing Address - Fax:
Practice Address - Street 1:4722 147TH ST
Practice Address - Street 2:SUITE 11
Practice Address - City:MIDLOTHIAN
Practice Address - State:IL
Practice Address - Zip Code:60445-2590
Practice Address - Country:US
Practice Address - Phone:708-307-0922
Practice Address - Fax:708-535-0141
Is Sole Proprietor?:No
Enumeration Date:2010-01-15
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0139871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical