Provider Demographics
NPI:1720807381
Name:WERNER, DANA MICHELE (EDS, MSW, LSW)
Entity type:Individual
Prefix:MRS
First Name:DANA
Middle Name:MICHELE
Last Name:WERNER
Suffix:
Gender:F
Credentials:EDS, MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39W908 CARL SANDBURG RD
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60175-7748
Mailing Address - Country:US
Mailing Address - Phone:630-624-6501
Mailing Address - Fax:
Practice Address - Street 1:3755 E MAIN ST STE 190
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-2463
Practice Address - Country:US
Practice Address - Phone:630-549-6245
Practice Address - Fax:630-701-9500
Is Sole Proprietor?:No
Enumeration Date:2024-10-09
Last Update Date:2024-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL9445261041S0200X
IL150010471104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool