Provider Demographics
NPI:1205988169
Name:GRANADOS, VALERIE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:
Last Name:GRANADOS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5452 N NEWCASTLE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60656-2052
Mailing Address - Country:US
Mailing Address - Phone:773-763-4665
Mailing Address - Fax:773-763-4665
Practice Address - Street 1:5452 N NEWCASTLE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60656-2052
Practice Address - Country:US
Practice Address - Phone:773-763-4665
Practice Address - Fax:773-763-4665
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor