Provider Demographics
NPI:1588477426
Name:TRUBEY-HOCKMAN, CHARLA (MSW, LSW, MASJ)
Entity type:Individual
Prefix:
First Name:CHARLA
Middle Name:
Last Name:TRUBEY-HOCKMAN
Suffix:
Gender:X
Credentials:MSW, LSW, MASJ
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2027 W BERWYN AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-8129
Mailing Address - Country:US
Mailing Address - Phone:909-997-8952
Mailing Address - Fax:
Practice Address - Street 1:2714 W PETERSON AVE LBBY 2
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-3920
Practice Address - Country:US
Practice Address - Phone:909-997-8952
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.112817104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker