Provider Demographics
NPI:1871768481
Name:BUDROW, STEPHANIE ERIN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:ERIN
Last Name:BUDROW
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 1:2665 HADDASSAH DR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60565-3067
Mailing Address - Country:US
Mailing Address - Phone:847-772-2765
Mailing Address - Fax:
Practice Address - Street 1:3380 LACROSSE LN # 116
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-8520
Practice Address - Country:US
Practice Address - Phone:847-772-2765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-24
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.010028104100000X
IL149.0133881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker