Organization
A PROMISE FOR PARENTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DENICE MARIE MOCK MSW LCSW ABD (DIRECTOR/OWNER)
(815) 758-1358
Entity
Organization
Contact information
Practice address
810 S 4TH ST, DEKALB, IL 60115-4410
(815) 758-1358
(815) 758-1580
Mailing address
810 S 4TH ST, DEKALB, IL 60115-4410
(815) 758-1358
(815) 758-1580
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149013457
IL
Other
Enumeration date
08/15/2016
Last updated
08/15/2016
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