Provider Demographics
NPI:1770812000
Name:BRINKMAN, MAUREEN ANN (LCSW)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:ANN
Last Name:BRINKMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MAUREEN
Other - Middle Name:ANN
Other - Last Name:SCALLON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:9631 W 153RD ST
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-3774
Mailing Address - Country:US
Mailing Address - Phone:630-281-0150
Mailing Address - Fax:
Practice Address - Street 1:9631 W 153RD ST
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-3774
Practice Address - Country:US
Practice Address - Phone:630-281-0150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-16
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0114141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical