Provider Demographics
NPI:1740681972
Name:ARNOL KAUFMAN, ALYSSA (LCSW)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:ARNOL KAUFMAN
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 1:1536 HACKBERRY RD
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-3960
Mailing Address - Country:US
Mailing Address - Phone:847-624-1515
Mailing Address - Fax:
Practice Address - Street 1:1536 HACKBERRY RD
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-3960
Practice Address - Country:US
Practice Address - Phone:847-624-1515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-08
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.015446104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker