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General NPI Number Information
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NPI Number | 1255824116
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Entity Type | Individual
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Provider Name | DELLIAH RENEE ADESANYA LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/14/2018
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 125 S WACKER DR STE 300
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City | CHICAGO
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State | IL
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Zip | 60606-4421
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Country | US
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Telephone | 312-835-7039
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Fax | 469-421-8594
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Provider Business Mailing Address
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Address Line | 125 S WACKER DR STE 300
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City | CHICAGO
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State | IL
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Zip | 60606-4421
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Country | US
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Telephone | 312-835-7039
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Fax | 469-421-8594
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149.023836
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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 | 109987
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801118646
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 34011437A
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License Number State | IN
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW025226
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License Number State | PA
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Taxonomy #6
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 248.003970
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License Number State | IL
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