Healthcare Provider Details

I. General information

NPI: 1174840573
Provider Name (Legal Business Name): HELEN REDMOND LCSW CADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2010
Last Update Date: 05/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 W HARRISON ST
CHICAGO IL
60612-3714
US

IV. Provider business mailing address

1525 S SANGAMON ST #310
CHICAGO IL
60608-1069
US

V. Phone/Fax

Practice location:
  • Phone: 312-864-6135
  • Fax:
Mailing address:
  • Phone: 312-455-0999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number23329
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149006863
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: