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NPI Code Detail

MEDICARE: DIAMOND FLOURNOY LCSW

MEDICARE: DIAMOND FLOURNOY 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 Worker149.026966IL

General Provider Information

NPI Number : 1477449288
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIAMOND FLOURNOY LCSW
Provider Business Mailing Address
First Line : 680 N LAKE SHORE DR
Second Line : SUITE 110 - 2873
City : CHICAGO
State : IL
Zip : 60611
Country : US
Telephone Number : 630-697-7780
Fax Number :
Provider Business Practice Location Address
First Line : 680 N LAKE SHORE DR
Second Line : SUITE 110 - 2873
City : CHICAGO
State : IL
Zip : 60611
Country : US
Telephone Number : 630-697-7780
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2025
Last Update Date : 07/03/2025

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Directions to “ DIAMOND FLOURNOY LCSW” Practice Location

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