Provider Demographics
NPI:1811082597
Name:CATLEDGE, DIONNE (MSW)
Entity type:Individual
Prefix:MS
First Name:DIONNE
Middle Name:
Last Name:CATLEDGE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1122 WESTGATE ST STE 203A&B
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60301-1170
Mailing Address - Country:US
Mailing Address - Phone:708-369-0653
Mailing Address - Fax:708-469-0653
Practice Address - Street 1:1122 WESTGATE ST STE 203A&B
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1170
Practice Address - Country:US
Practice Address - Phone:708-369-0653
Practice Address - Fax:708-469-4718
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0134561041C0700X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical