Provider Demographics
NPI:1578186813
Name:MCCOOL, JENNIFER MOLLY (LCSW)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MOLLY
Last Name:MCCOOL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4516 S SPRINGFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60632-4042
Mailing Address - Country:US
Mailing Address - Phone:847-502-1155
Mailing Address - Fax:
Practice Address - Street 1:4516 S SPRINGFIELD AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60632-4042
Practice Address - Country:US
Practice Address - Phone:847-502-1155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-21
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical