Ellen Giacobbe, LCSW

Individual provider Active NPI Clinical Social Worker · East Dundee, IL

NPI 1780181487 · NPPES record last updated Jul 24, 2023

Key facts

NPI
1780181487
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
149.020189 (IL)
Practice address
101 S Van Buren St
East Dundee, IL 60118-2315
Phone
(815) 236-9718
NPI assigned
Apr 9, 2018
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
149.020189ILMDClinical Social Worker
994484ILMDSchool Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X 994484 IL
Clinical Social Worker 1041C0700X 149.020189 IL Yes

Addresses

Primary practice location

101 S Van Buren St
East Dundee, IL 60118-2315

Mailing address

101 S Van Buren St
East Dundee, IL 60118-2315
Phone (815) 236-9718

Other providers in East Dundee, IL

All providers in East Dundee, IL · Clinical Social Worker in Illinois

Sources for this page

Verify at the official NPI Registry.