Latrece Madison, LCSW
Social Worker, Clinical in Richton Park, IL. Individual provider (NPI-1).
NPI number1821892464
StatusActive
Last updated in NPPESApr 2, 2025
Details
- NPI
- 1821892464
- Entity type
- Individual (NPI-1)
- Name
- Latrece Madison
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 2, 2025
- Certification date
- Apr 2, 2025
- Last updated
- Apr 2, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 149029102 | IL | Yes |
Practice location
23005 Westwind DrRichton Park, IL 60471-2551
Phone 309-824-9619
Mailing address
23005 Westwind DrRichton Park, IL 60471-2551
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