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Diane Petersen, LCSW
NPI 1306187117 · on the registry since 2013
Practice
- Address
- 18640 W Il Route 120
Grayslake, IL 60030 - Phone
- (847) 548-6000
- Fax
- (847) 548-6040
- Organisation at this address
- Community Youth Network, Inc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 13
Registry record
- Primary taxonomy
- Clinical Social Worker
1041C0700X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2013-03-05
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois