Provider Demographics
NPI:1427079847
Name:LAUREANO, JERI LYNN (LCSW)
Entity type:Individual
Prefix:MS
First Name:JERI
Middle Name:LYNN
Last Name:LAUREANO
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 1:71 W FABISH DR
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-7013
Mailing Address - Country:US
Mailing Address - Phone:847-284-0430
Mailing Address - Fax:
Practice Address - Street 1:71 W FABISH DR
Practice Address - Street 2:
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-7013
Practice Address - Country:US
Practice Address - Phone:847-284-0430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
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