Provider Demographics
NPI:1336268408
Name:MAYS, JEAN (LCSW)
Entity type:Individual
Prefix:MS
First Name:JEAN
Middle Name:
Last Name:MAYS
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 1:1651 N ORCHARD ST APT 106
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-5398
Mailing Address - Country:US
Mailing Address - Phone:708-338-3806
Mailing Address - Fax:708-681-1289
Practice Address - Street 1:1820 S 25TH AVE
Practice Address - Street 2:
Practice Address - City:BROADVIEW
Practice Address - State:IL
Practice Address - Zip Code:60155-2864
Practice Address - Country:US
Practice Address - Phone:708-338-3806
Practice Address - Fax:708-681-1289
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490093531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical