Provider Demographics
NPI:1932536570
Name:NAGEL, BECKY JUNE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:BECKY
Middle Name:JUNE
Last Name:NAGEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5724 W CULLOM AVE UNIT 3
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634-1718
Mailing Address - Country:US
Mailing Address - Phone:312-391-0273
Mailing Address - Fax:
Practice Address - Street 1:1 E SUPERIOR ST STE 500B
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2593
Practice Address - Country:US
Practice Address - Phone:312-391-0273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-27
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0123971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical