Provider Demographics
NPI:1447651427
Name:GRUENWALD, SETH (LCSW)
Entity type:Individual
Prefix:
First Name:SETH
Middle Name:
Last Name:GRUENWALD
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 SUMAC CT
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60193-1566
Mailing Address - Country:US
Mailing Address - Phone:773-957-9371
Mailing Address - Fax:
Practice Address - Street 1:1S450 SUMMIT AVE STE 135
Practice Address - Street 2:
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181-3962
Practice Address - Country:US
Practice Address - Phone:630-629-3015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-10
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1501012591041C0700X
IL1490203781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical