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General NPI Number Information
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NPI Number | 1316686991
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Entity Type | Individual
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Provider Name | TABATHA JOHN PRICE LSW
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Gender | Female
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Dates
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Enumeration Date | 06/01/2022
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 1952 MCDOWELL RD UNIT 305
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City | NAPERVILLE
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State | IL
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Zip | 60563
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Country | US
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Telephone | 630-689-1022
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Fax |
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Provider Business Mailing Address
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Address Line | 2441 PLAINFIELD RD
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City | JOLIET
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State | IL
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Zip | 60435-1439
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Country | US
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Telephone | 630-815-1015
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Fax |
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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 | 1316686991
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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