Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Jerry Thomas Souta Jr, LCSW

Individual provider Clinical Social Worker · NPI 1831259829

Mr. Jerry Thomas Souta Jr, LCSW is a Clinical Social Worker in Melrose Park, Illinois. Licensed in Illinois. Registered with an NPI since 2006.

Licensed in
IL
In the registry since
2006
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

1414 Main St
Melrose Park, IL 60160-3902
Phone: (708) 681-0073
Fax: (708) 681-3958
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X (IL)

Record details

NPI number1831259829
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorNo
NPI enumeratedDecember 11, 2006
Last updated in NPPESJuly 8, 2007

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