Provider Demographics
NPI:1427711514
Name:MALINA, RHONDA C (LCSW)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:C
Last Name:MALINA
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 1:574 HYACINTH PL
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-1265
Mailing Address - Country:US
Mailing Address - Phone:847-433-0681
Mailing Address - Fax:
Practice Address - Street 1:5901 N CICERO AVE STE 210
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-5718
Practice Address - Country:US
Practice Address - Phone:847-363-3038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-15
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0142241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical