Provider Demographics
NPI:1962701300
Name:RAFAEL, DEBBIE P (MSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:DEBBIE
Middle Name:P
Last Name:RAFAEL
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 W MONROE ST
Mailing Address - Street 2:#611
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-2565
Mailing Address - Country:US
Mailing Address - Phone:773-742-2787
Mailing Address - Fax:773-904-2577
Practice Address - Street 1:1200 W MONROE ST
Practice Address - Street 2:#611
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-2565
Practice Address - Country:US
Practice Address - Phone:773-742-2787
Practice Address - Fax:773-904-2577
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-24
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490125051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical