Provider Demographics
NPI:1700518313
Name:STRICKER, JEANINE MARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:JEANINE
Middle Name:MARIE
Last Name:STRICKER
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 1:529 TELLURIDE DR
Mailing Address - Street 2:
Mailing Address - City:GILBERTS
Mailing Address - State:IL
Mailing Address - Zip Code:60136-4020
Mailing Address - Country:US
Mailing Address - Phone:177-362-1089
Mailing Address - Fax:
Practice Address - Street 1:529 TELLURIDE DR
Practice Address - Street 2:
Practice Address - City:GILBERTS
Practice Address - State:IL
Practice Address - Zip Code:60136-4020
Practice Address - Country:US
Practice Address - Phone:177-362-1089
Practice Address - Fax:312-858-5498
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-30
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490153561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical