Provider Demographics
NPI:1053415406
Name:CORWIN, NINA (MA LCSW)
Entity type:Individual
Prefix:
First Name:NINA
Middle Name:
Last Name:CORWIN
Suffix:
Gender:F
Credentials:MA LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1242 S FEDERAL ST UNIT E
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-3389
Mailing Address - Country:US
Mailing Address - Phone:312-504-8161
Mailing Address - Fax:312-786-9121
Practice Address - Street 1:1242 S FEDERAL ST UNIT E
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-3389
Practice Address - Country:US
Practice Address - Phone:312-504-8161
Practice Address - Fax:312-786-9121
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILILSWL1490020101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical