Individual provider · Type 1 NPI

Jerry Thomas Souta JR, LCSW

Clinical Social Worker · Melrose Park, IL

NPI number 1831259829 Active

Practice location

1414 Main St
Melrose Park, IL 60160-3902

Call (708) 681-0073 Map

Fax (708) 681-3958

Mailing address

21459 W Basswood Ln
Plainfield, IL 60544-6367

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700XNone listed

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1831259829

Jerry Thomas Souta JR, LCSW's National Provider Identifier is 1831259829, issued on Dec 11, 2006. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Melrose Park, IL. The record was last updated on Jul 8, 2007.