Provider Demographics
NPI:1609221340
Name:MILLETT, MARIA (LCSW)
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:
Last Name:MILLETT
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 1:6007 N SHERIDAN RD APT 11G
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-3062
Mailing Address - Country:US
Mailing Address - Phone:989-513-3261
Mailing Address - Fax:
Practice Address - Street 1:6007 N SHERIDAN RD APT 11G
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60660-3062
Practice Address - Country:US
Practice Address - Phone:989-513-3261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-02
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0197931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical