Christopher Dominguez, Licensed Social Work
Social Worker, Clinical in Chicago, IL. Individual provider (NPI-1).
NPI number1831803444
StatusActive
Last updated in NPPESMay 16, 2024
Details
- NPI
- 1831803444
- Entity type
- Individual (NPI-1)
- Name
- Christopher Dominguez
- Credential
- Licensed Social Work
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jan 9, 2023
- Certification date
- May 16, 2024
- Last updated
- May 16, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 149.025775 | IL | Yes |
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | 37399 | IL |
Practice location
1701 W Superior StChicago, IL 60622-5646
Phone 312-666-3494
Mailing address
2747 S Avers AveChicago, IL 60623-4510
Phone 708-336-9208
Other practice locations
708 Church St Ste 247
Evanston, IL 60201-3840
Evanston, IL 60201-3840
Phone 773-357-6152
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