Doctor Name: | MR. DOUGLAS S LABELLE |
NPI Number: | 1356475842 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | 6891123 |
Business Practice Address: | 655 Rockland Rd Ste. 103 Lake Bluff, IL - 600441782 |
Business Phone Number: | 8473093781 |
Business Fax Number: | 8474821688 |
Mailing Address: | 655 Rockland Rd, Ste. 103 LAKE BLUFF |
State: | IL |
Postal Code: | 600441782 |
Phone Number: | 8473093781 |
Fax Number: | 8474821688 |
NPI Enumeration Date: | 03/15/2007 |
NPI Last Update Date: | 01/16/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 6891123 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |