Provider Demographics
NPI:1972713501
Name:NOWAK, BARBARA JUNE (LCSW)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:JUNE
Last Name:NOWAK
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 1:210 NORTH COMMERCIAL ST.
Mailing Address - Street 2:
Mailing Address - City:BAILEYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61007-0076
Mailing Address - Country:US
Mailing Address - Phone:815-232-5536
Mailing Address - Fax:
Practice Address - Street 1:210 NORTH COMMERCIAL ST.
Practice Address - Street 2:
Practice Address - City:BAILEYVILLE
Practice Address - State:IL
Practice Address - Zip Code:61007-0076
Practice Address - Country:US
Practice Address - Phone:815-232-5536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490082461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical