Provider Demographics
NPI:1285073585
Name:MCGOWAN, RENEE BERIOU (LCSW)
Entity type:Individual
Prefix:MS
First Name:RENEE
Middle Name:BERIOU
Last Name:MCGOWAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:RENEE
Other - Middle Name:BERIOU
Other - Last Name:STRONCEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1560 N SANDBURG TER
Mailing Address - Street 2:SUITE 1401
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-1351
Mailing Address - Country:US
Mailing Address - Phone:312-614-0849
Mailing Address - Fax:
Practice Address - Street 1:1560 N SANDBURG TER
Practice Address - Street 2:SUITE 1401
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-1351
Practice Address - Country:US
Practice Address - Phone:312-614-0849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-19
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490138461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical