Healthcare Provider Details

I. General information

NPI: 1114545548
Provider Name (Legal Business Name): CHRISTINA ROBERTSON LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2020
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1552 S ROUTE 59 # 1127
NAPERVILLE IL
60564-5941
US

IV. Provider business mailing address

1552 S ROUTE 59 # 1127
NAPERVILLE IL
60564-5941
US

V. Phone/Fax

Practice location:
  • Phone: 708-320-9224
  • Fax:
Mailing address:
  • Phone: 708-320-9224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180017017
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: