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General NPI Number Information
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NPI Number | 1669856191
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Entity Type | Individual
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Provider Name | JEMIMA HASULUBE LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/14/2015
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Last Update Date | 01/27/2026
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Provider Practice Location Address
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Address Line | 2410 SUNFLOWER CT
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City | AURORA
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State | IL
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Zip | 60506-1547
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Country | US
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Telephone | 630-687-2664
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Fax |
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Provider Business Mailing Address
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Address Line | 7 S STOLP AVE APT 1107
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City | AURORA
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State | IL
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Zip | 60506-6536
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Country | US
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Telephone | 630-687-2664
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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 | 130067
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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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 | 149023869
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License Number State | IL
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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 | 33574
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License Number State | MN
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