Provider Demographics
NPI:1992982243
Name:SEGALL, NANCY T (LCSW)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:T
Last Name:SEGALL
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 1:1131 SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-1441
Mailing Address - Country:US
Mailing Address - Phone:847-864-9557
Mailing Address - Fax:847-864-7957
Practice Address - Street 1:1131 SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-1441
Practice Address - Country:US
Practice Address - Phone:847-864-9557
Practice Address - Fax:847-864-7957
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-29
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical