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Individual

MRS. REBECCA SAMOLITIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
116 W LAFAYETTE ST, SUITE 8, OTTAWA, IL 61350
(815) 488-1704
(815) 433-3980
Mailing address
116 W LAFAYETTE ST, SUITE 8, OTTAWA, IL 61350
(815) 488-1704
(815) 433-3980

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
149.013808
IL
1041C0700X
Clinical Social Worker
149.013808
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
149.013808
LCSW
IL
Enumeration date
02/10/2010
Last updated
06/04/2019
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