NPI 1003343096

Jorge Roman

Practitioner Clinical Social Worker Crystal Lake, IL

Practice location

Address: 650 Dakota St STE a, Crystal Lake, IL 60012-3744
Phone: (815) 334-5018
Fax: (815) 356-1104

Registered specialties (2)

Clinical Social Worker Primary

Behavioral Health & Social Service Providers Taxonomy 1041C0700X Licence 149023741 (IL)

Other Social Worker providers in Illinois →

Mental Health Counselor

Behavioral Health & Social Service Providers Taxonomy 101YM0800X

Other Counselor providers in Illinois →

Registry record

NPI: 1003343096
Entity type: Individual
Sex (as registered): Male
NPI issued: 22 May 2017
Record last updated: 12 Apr 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.