Healthcare Provider Details
I. General information
NPI: 1770678898
Provider Name (Legal Business Name): LEANNE RAE GILBERG LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/04/2006
Last Update Date: 12/21/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3077 W JEFFERSON ST SUITE 108
JOLIET IL
60435-5262
US
IV. Provider business mailing address
25234 W. TOWPATH LANE
CHANNAHON IL
60410-9322
US
V. Phone/Fax
- Phone: 816-260-4020
- Fax:
- Phone: 815-467-6651
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041S0200X |
| Taxonomy | School Social Worker |
| License Number | TYPE 73 CERTIFICATE |
| License Number State | IL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: