Provider Demographics
NPI:1053180513
Name:GLIBKOWSKI, JENNIFER K (LCSW)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:K
Last Name:GLIBKOWSKI
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 1:165 N KENILWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN ELLYN
Mailing Address - State:IL
Mailing Address - Zip Code:60137-5384
Mailing Address - Country:US
Mailing Address - Phone:312-493-1395
Mailing Address - Fax:
Practice Address - Street 1:165 N KENILWORTH AVE
Practice Address - Street 2:
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-5384
Practice Address - Country:US
Practice Address - Phone:312-493-1395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-26
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490124191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical