Suellen Shively-Mack, L.C.S.W.

NPI #1205197415 in Elgin, Illinois

Provider Information

NPI Number: 1205197415
Entity Type: Individual
Name: Suellen Shively-Mack, L.C.S.W.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker - Clinical
Credential: L.C.S.W.
Enumeration Date: Jun 4, 2012
Last Updated: Jun 4, 2012

Practice Location

Address: 240 STANDISH ST
City: Elgin
State: Illinois
ZIP Code: 60123-6421
Phone: (847) 742-5717

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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