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General NPI Number Information
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NPI Number | 1093328486
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Entity Type | Individual
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Provider Name | MARLENA CHRISTINE GEBHARD LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/26/2020
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Last Update Date | 05/31/2025
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Provider Practice Location Address
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Address Line | 5145 N CLARK ST # 1099
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City | CHICAGO
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State | IL
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Zip | 60640-2829
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Country | US
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Telephone | 615-521-1071
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Fax |
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Provider Business Mailing Address
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Address Line | 1090 S WADSWORTH BLVD STE C
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City | LAKEWOOD
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State | CO
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Zip | 80226-4350
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Country | US
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Telephone | 970-414-7606
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Fax | 970-834-6873
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 150.104560
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149.025532
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License Number State | IL
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