Provider Demographics
NPI:1770352072
Name:PARAS, SEAN MICHAEL (LCSW, CADC, CRSS)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:MICHAEL
Last Name:PARAS
Suffix:
Gender:M
Credentials:LCSW, CADC, CRSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1639 N ALPINE RD STE 260
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61107-1481
Mailing Address - Country:US
Mailing Address - Phone:815-246-5213
Mailing Address - Fax:
Practice Address - Street 1:5113 S HARPER AVE STE 2C
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60615-4119
Practice Address - Country:US
Practice Address - Phone:312-300-3149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-27
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL35594101YA0400X
IL31738175T00000X
IL149.0260971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No175T00000XOther Service ProvidersPeer Specialist