Provider Demographics
NPI:1902905680
Name:CLOUSE, DENNY (MSW/LCSW)
Entity Type:Individual
Prefix:MR
First Name:DENNY
Middle Name:
Last Name:CLOUSE
Suffix:
Gender:M
Credentials:MSW/LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 E MAIN ST STE 40
Mailing Address - Street 2:
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-2363
Mailing Address - Country:US
Mailing Address - Phone:630-513-6277
Mailing Address - Fax:630-513-4277
Practice Address - Street 1:1750 E MAIN ST STE 40
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-2363
Practice Address - Country:US
Practice Address - Phone:630-513-6277
Practice Address - Fax:630-513-4277
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical