Doctor Name: | DAMARIS VELAZQUEZ |
NPI Number: | 1003277500 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 149012663 |
Business Practice Address: | 2244 S 11th Ave North Riverside, IL - 605461123 |
Business Phone Number: | 7734031215 |
Business Fax Number: | |
Mailing Address: | 2244 S 11th Ave, NORTH RIVERSIDE |
State: | IL |
Postal Code: | 605461123 |
Phone Number: | 7734031215 |
Fax Number: | |
NPI Enumeration Date: | 03/10/2016 |
NPI Last Update Date: | 03/10/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 149012663 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |