Provider Demographics
NPI:1982776662
Name:JAMES, ANN CATHERINE KNUTSON (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:CATHERINE KNUTSON
Last Name:JAMES
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1639 N ALPINE RD STE 204
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61107-1481
Mailing Address - Country:US
Mailing Address - Phone:779-423-0275
Mailing Address - Fax:
Practice Address - Street 1:1639 N ALPINE RD STE 204
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-1481
Practice Address - Country:US
Practice Address - Phone:779-423-0275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0118811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical