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NPI Code Detail

MEDICARE: SEAN HERBERT LCSW

MEDICARE: SEAN HERBERT 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 Worker149.025978IL

General Provider Information

NPI Number : 1790598217
Entity Type Code : Individual
Provider Name (Legal Business Name) : SEAN HERBERT LCSW
Provider Business Mailing Address
First Line : 777 W ARMY TRAIL BLVD FL 2
Second Line :
City : ADDISON
State : IL
Zip : 60101-3163
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 777 W ARMY TRAIL BLVD FL 2
Second Line :
City : ADDISON
State : IL
Zip : 60101-3163
Country : US
Telephone Number : 630-693-7934
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2025
Last Update Date : 01/29/2025

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