Phyllis Ferguson Collum, LCSW
Social Worker, Clinical in Dolton, IL. Individual provider (NPI-1).
NPI number1902202054
StatusActive
Last updated in NPPESApr 4, 2024
Details
- NPI
- 1902202054
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Phyllis Ferguson Collum
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Nov 17, 2014
- Certification date
- Apr 4, 2024
- Last updated
- Apr 4, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 149015907 | IL | Yes |
| 101YM0800X | Counselor, Mental Health | 149015907 | IL | |
| 101YP2500X | Counselor, Professional | 149015907 | IL |
Practice location
15539 Dobson AveDolton, IL 60419-2708
Phone 312-810-5203 · Fax 773-654-3875
Mailing address
15539 Dobson AveDolton, IL 60419-2708
Phone 312-810-5203 · Fax 773-654-3875
Other practice locations
9550 W 167th St Ste 100
Orland Park, IL 60467-5561
Orland Park, IL 60467-5561
Phone 708-478-3960
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Other Clinical Social Worker providers in Dolton, IL
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- Yazmine Nicole Howard, LCSWNPI 1720702541
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- Paris WilliamsNPI 1265145643
All 6 Clinical Social Worker providers in Dolton · All 211 providers in Dolton
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