Healthcare Provider Details

I. General information

NPI: 1265960769
Provider Name (Legal Business Name): LORENA ISABEL MAPOSITO MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2017
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5101 WASHINGTON ST # 207
GURNEE IL
60031-5916
US

IV. Provider business mailing address

2403 PLUM TREE RD
LINDENHURST IL
60046-8941
US

V. Phone/Fax

Practice location:
  • Phone: 860-793-7241
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149022810
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: