Individual
ANGELITA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1925 N ILLINOIS 83, GRAYSLAKE, IL 60030
(847) 986-3100
Mailing address
61 CRISFIELD DR, GRAYSLAKE, IL 60030-7911
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.105319
IL
1041C0700X
Clinical Social Worker
149.028966
IL
Other
Enumeration date
03/11/2024
Last updated
03/17/2025
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