Individual
CLAUDIA C FUENTES-PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW, QMHP
Contact information
Practice address
1100 S MAY ST, CHICAGO, IL 60607-4229
(312) 602-1460
(312) 733-5211
Mailing address
1100 S MAY ST, CHICAGO, IL 60607-4229
(312) 602-1460
(312) 733-5211
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1407971211
IL
1041C0700X
Clinical Social Worker
Primary
149.026541
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
362170821019
—
IL
Enumeration date
11/25/2014
Last updated
11/20/2024
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