Healthcare Provider Details

I. General information

NPI: 1598079584
Provider Name (Legal Business Name): KOREY JAMES LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2010
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

919 SEQUOIA RUBY CT
HENDERSON NV
89052-8656
US

IV. Provider business mailing address

919 SEQUOIA RUBY CT
HENDERSON NV
89052-8656
US

V. Phone/Fax

Practice location:
  • Phone: 312-612-9860
  • Fax:
Mailing address:
  • Phone: 312-612-9860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number12215-C
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.020882
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: