Souta Jr, Jerry Thomas

Souta Jr, Jerry Thomas is an individual health care provider with primary practice located at 1414 Main St , Melrose Park IL 60160-3902. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Souta Jr, Jerry Thomas can be contacted via phone (708) 681-0073.

Contact Information

Primary practice address
1414 Main St Melrose Park IL 60160-3902
Phone: (708) 681-0073
Fax: (708) 681-3958
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X Illinois

Profile Details

NPI number 1831259829
LBN Legal business name Souta Jr, Jerry Thomas
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 11th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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