Stanislaus, Connie S

Stanislaus, Connie S is an individual health care provider with primary practice located at 114 W Rockland Rd , Libertyville IL 60060. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Stanislaus, Connie S can be contacted via phone (847) 816-9180.

Contact Information

Primary practice address
114 W Rockland Rd Libertyville IL 60060
Phone: (847) 816-9180
Fax: (847) 816-9183
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X Illinois

Profile Details

NPI number 1013032192
LBN Legal business name Stanislaus, Connie S
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 20th, 2007
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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Identifiers

StateTypeNumberIssuer
All States NPI 1013032192 NPPES
Illinois Other 1295897148 NATIONAL ID GROUP

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