Provider Demographics
NPI:1740505577
Name:LEPONTOIS, JOAN IRENE (LCSW)
Entity type:Individual
Prefix:MS
First Name:JOAN
Middle Name:IRENE
Last Name:LEPONTOIS
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 1:2639 W ESTES AVE APT 1W
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-3225
Mailing Address - Country:US
Mailing Address - Phone:773-761-4998
Mailing Address - Fax:
Practice Address - Street 1:5544 N WESTERN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-2217
Practice Address - Country:US
Practice Address - Phone:773-561-5400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-05
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0009101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical