Provider Demographics
NPI:1548483480
Name:MOHNING, KURT MATTHEW (LCSW)
Entity type:Individual
Prefix:MR
First Name:KURT
Middle Name:MATTHEW
Last Name:MOHNING
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2417 W MORSE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-4611
Mailing Address - Country:US
Mailing Address - Phone:773-319-4325
Mailing Address - Fax:
Practice Address - Street 1:4633 N WESTERN AVE
Practice Address - Street 2:STE 211
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-2181
Practice Address - Country:US
Practice Address - Phone:773-769-3573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150-0100181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL150-010018OtherSTATE LICENSE NUMBER