Individual
ALYSSA RACHELLE NAGENGAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
800 N WESTMORELAND RD STE 201, LAKE FOREST, IL 60045-1687
(847) 388-0603
(312) 694-1155
Mailing address
800 N WESTMORELAND RD STE 201, LAKE FOREST, IL 60045-1687
(847) 388-0603
(312) 694-1155
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
149022946
IL
1041C0700X
Clinical Social Worker
Primary
149022946
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/25/2017
Last updated
11/01/2024
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