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NPI Code Detail

MEDICARE: BETH REDDING LCSW

MEDICARE:   BETH  REDDING  LCSW
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 Worker149011289IL

General Provider Information

NPI Number : 1144628520
Entity Type Code : Individual
Provider Name (Legal Business Name) : BETH REDDING LCSW
Provider Business Mailing Address
First Line : 2700 PATRIOT BLVD STE 250
Second Line :
City : GLENVIEW
State : IL
Zip : 60026-8021
Country : US
Telephone Number : 312-756-0468
Fax Number :
Provider Business Practice Location Address
First Line : 7433 N CLARK ST
Second Line :
City : CHICAGO
State : IL
Zip : 60626-1619
Country : US
Telephone Number : 312-756-0468
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/17/2014
Last Update Date : 12/17/2014

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Directions to “ BETH REDDING LCSW” Practice Location

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