Provider Demographics
NPI:1154184059
Name:HUTCHISON, MARIANNE WINIFRED (LCSW)
Entity type:Individual
Prefix:
First Name:MARIANNE
Middle Name:WINIFRED
Last Name:HUTCHISON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MARIANNE
Other - Middle Name:
Other - Last Name:URBINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2030 N SEMINARY AVE
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:IL
Mailing Address - Zip Code:60098-2626
Mailing Address - Country:US
Mailing Address - Phone:815-679-4649
Mailing Address - Fax:
Practice Address - Street 1:2030 N SEMINARY AVE
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:IL
Practice Address - Zip Code:60098-2626
Practice Address - Country:US
Practice Address - Phone:815-679-4649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-02
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0264351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical