Provider Demographics
NPI:1649699745
Name:WHITE, ROBYN DANIELLE (LCSW)
Entity type:Individual
Prefix:MS
First Name:ROBYN
Middle Name:DANIELLE
Last Name:WHITE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:834 E. 50TH STREET
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615
Mailing Address - Country:US
Mailing Address - Phone:773-358-6767
Mailing Address - Fax:773-538-4999
Practice Address - Street 1:834 E 50TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60615-2620
Practice Address - Country:US
Practice Address - Phone:773-358-6767
Practice Address - Fax:773-538-4999
Is Sole Proprietor?:No
Enumeration Date:2014-04-16
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490159741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical