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Jason Maurice Burnett, LCSW

Social Worker, Clinical in Forest Park, IL. Individual provider (NPI-1).

NPI number1033765326
StatusActive
Last updated in NPPESAug 13, 2019

Details

NPI
1033765326
Entity type
Individual (NPI-1)
Name
Jason Maurice Burnett
Credential
LCSW
Sex
Male
Sole proprietor
No
Enumeration date
Aug 13, 2019
Last updated
Aug 13, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, Clinical149021328ILYes

Practice location

1029 Des Plaines Ave Apt 404
Forest Park, IL 60130-2146

Phone 312-342-7504

Mailing address

1029 Des Plaines Ave Apt 404
Forest Park, IL 60130-2146

Phone 312-342-7504

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