Provider Demographics
NPI:1891411401
Name:MCLAUGHLIN, SHELLEY (MSW LSW LCSW)
Entity type:Individual
Prefix:
First Name:SHELLEY
Middle Name:
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:MSW LSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10121 S PEORIA ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-2224
Mailing Address - Country:US
Mailing Address - Phone:708-956-4043
Mailing Address - Fax:
Practice Address - Street 1:10121 S PEORIA ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-2224
Practice Address - Country:US
Practice Address - Phone:708-956-4043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-14
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0272321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL17014Medicaid