| Charles F Small Lcsw Llc | |
|
1465 W Grand Ave Apt 3 Chicago IL 60642-8532 | |
| (773) 307-1045 | |
| Not Available |
| Full Name | Charles F Small Lcsw Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1465 W Grand Ave Apt 3, Chicago, Illinois |
| Authorized Official Name and Position | Charles F Small (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 7733071045 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Charles F Small Lcsw Llc 1465 W Grand Ave Apt 3 Chicago IL 60642-8532 Ph: (773) 307-1045 | Charles F Small Lcsw Llc 1465 W Grand Ave Apt 3 Chicago IL 60642-8532 Ph: (773) 307-1045 |
| NPI Number | 1144797440 |
|---|---|
| Provider Enumeration Date | 10/25/2018 |
| Last Update Date | 10/25/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144797440 | NPI | - | NPPES |
| 149.015676 | Other | IL | PROFESSIONAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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