Healthcare Provider Details

I. General information

NPI: 1720527229
Provider Name (Legal Business Name): SHERRI NAHIN LCSW, CADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2017
Last Update Date: 02/16/2017
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

70 W HURON ST APT 407
CHICAGO IL
60654-5333
US

V. Phone/Fax

Practice location:
  • Phone: 312-864-7760
  • Fax: 312-864-9705
Mailing address:
  • Phone: 312-925-7295
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number31657
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149017790
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: