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NPI Code Detail

MEDICARE: WHITNEY LYNN LECOCQ LCSW, CADC

MEDICARE: WHITNEY LYNN LECOCQ LCSW, CADC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker149.017478IL

General Provider Information

NPI Number : 1043708316
Entity Type Code : Individual
Provider Name (Legal Business Name) : WHITNEY LYNN LECOCQ LCSW, CADC
Provider Business Mailing Address
First Line : 1026 WEBSTER AVE
Second Line :
City : WHEATON
State : IL
Zip : 60187-4379
Country : US
Telephone Number : 253-720-4216
Fax Number :
Provider Business Practice Location Address
First Line : 1500 EISENHOWER LN STE 900
Second Line :
City : LISLE
State : IL
Zip : 60532-2135
Country : US
Telephone Number : 630-428-7890
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2018
Last Update Date : 04/23/2018

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