Provider Demographics
NPI:1225364516
Name:CAIN, MICHELLE CATHERINE (LCSW)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:CATHERINE
Last Name:CAIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4456 N BEACON ST APT G
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-5555
Mailing Address - Country:US
Mailing Address - Phone:630-452-2494
Mailing Address - Fax:
Practice Address - Street 1:1750 N KINGSBURY ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-4813
Practice Address - Country:US
Practice Address - Phone:630-452-2492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-22
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0135561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical