Provider Demographics
NPI:1396949897
Name:LENNEBERG, JOHANNA SONNENFELD (LCSW)
Entity type:Individual
Prefix:MS
First Name:JOHANNA
Middle Name:SONNENFELD
Last Name:LENNEBERG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:JOHANNA
Other - Middle Name:
Other - Last Name:SONNENFELD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:2400 N LAKEVIEW AVE
Mailing Address - Street 2:#3006
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-2747
Mailing Address - Country:US
Mailing Address - Phone:773-248-2115
Mailing Address - Fax:
Practice Address - Street 1:2400 N LAKEVIEW AVE
Practice Address - Street 2:#3006
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-2747
Practice Address - Country:US
Practice Address - Phone:773-248-2115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical