Provider Demographics
NPI:1659175065
Name:CASADY, CAROLYN JEAN (LCSW)
Entity type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:JEAN
Last Name:CASADY
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1434 W HOLLYWOOD AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-4509
Mailing Address - Country:US
Mailing Address - Phone:847-274-8564
Mailing Address - Fax:
Practice Address - Street 1:1645 W JACKSON BLVD STE 600
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-2847
Practice Address - Country:US
Practice Address - Phone:312-947-2986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0228151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical