| Emily Hanneman, Lcsw Pllc | |
|
4809 N Ravenswood Ave Unit 319a Chicago IL 60640-6648 | |
| (312) 650-9025 | |
| Not Available |
| Full Name | Emily Hanneman, Lcsw Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 4809 N Ravenswood Ave Unit 319a, Chicago, Illinois |
| Authorized Official Name and Position | Emily Hanneman (OWNER & THERAPIST) |
| Authorized Official Contact | 3126509025 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Emily Hanneman, Lcsw Pllc 4809 N Ravenswood Ave Unit 319a Chicago IL 60640-6648 Ph: (312) 650-9025 | Emily Hanneman, Lcsw Pllc 4809 N Ravenswood Ave Unit 319a Chicago IL 60640-6648 Ph: (312) 650-9025 |
| NPI Number | 1790320158 |
|---|---|
| Provider Enumeration Date | 11/08/2019 |
| Last Update Date | 09/06/2024 |
| Certification Date | 09/06/2024 |
| Medicare PECOS PAC ID | 4082092267 |
|---|---|
| Medicare Enrollment ID | O20220531000600 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790320158 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Emily Hanneman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609436294 PECOS PAC ID: 5193057958 Enrollment ID: I20191028001888 |
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