Dan Philip Mattias Bestrom, LCSW
Social Worker, Clinical in Chicago, IL. Individual provider (NPI-1).
NPI number1710366604
StatusActive
Last updated in NPPESJul 20, 2015
Details
- NPI
- 1710366604
- Entity type
- Individual (NPI-1)
- Name
- Dan Philip Mattias Bestrom
- Credential
- LCSW
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- May 25, 2015
- Last updated
- Jul 20, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 149.017454 | IL | Yes |
Practice location
30 N Michigan AveChicago, IL 60602-3402
Phone 872-333-9803
Mailing address
30 N Michigan AveChicago, IL 60602-3402
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