Provider Demographics
NPI:1487827572
Name:ARBUTHNOT, MARY (LCSW)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:ARBUTHNOT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:
Other - Last Name:HOULIHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:203 N OTTAWA ST
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60432-4006
Mailing Address - Country:US
Mailing Address - Phone:800-240-7011
Mailing Address - Fax:
Practice Address - Street 1:26 W SAINT CHARLES RD
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-2229
Practice Address - Country:US
Practice Address - Phone:800-240-7011
Practice Address - Fax:630-495-9854
Is Sole Proprietor?:No
Enumeration Date:2008-04-09
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490090941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical