Provider Demographics
NPI:1316737778
Name:GETZENDANNER, PAUL (LCSW)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:GETZENDANNER
Suffix:
Gender:X
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:559 ARBOR VITAE RD
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:IL
Mailing Address - Zip Code:60093-2301
Mailing Address - Country:US
Mailing Address - Phone:773-519-0319
Mailing Address - Fax:
Practice Address - Street 1:559 ARBOR VITAE RD
Practice Address - Street 2:
Practice Address - City:WINNETKA
Practice Address - State:IL
Practice Address - Zip Code:60093-2301
Practice Address - Country:US
Practice Address - Phone:773-519-0319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490156131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical