Individual
DOUGLAS S BLASINSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
304 WANDER WAY, LAKE IN THE HILLS, IL 60156-4707
(847) 347-0177
Mailing address
304 WANDER WAY, LAKE IN THE HILLS, IL 60156-4707
(847) 347-0177
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
130043-121
WI
1041C0700X
Clinical Social Worker
Primary
149022464
IL
1041C0700X
Clinical Social Worker
8910-123
WI
Other
Enumeration date
06/21/2016
Last updated
08/27/2020
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