Provider Demographics
NPI:1912985359
Name:KATZ-ATKIN, GERALDINE JOYCE (AM LCSW)
Entity Type:Individual
Prefix:
First Name:GERALDINE
Middle Name:JOYCE
Last Name:KATZ-ATKIN
Suffix:
Gender:F
Credentials:AM LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 E LIBERTY DR APT 605
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-5428
Mailing Address - Country:US
Mailing Address - Phone:630-269-3726
Mailing Address - Fax:
Practice Address - Street 1:255 E LIBERTY DR APT 605
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-5428
Practice Address - Country:US
Practice Address - Phone:630-942-9370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-05
Last Update Date:2023-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490037541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical