Healthcare Provider Details

I. General information

NPI: 1932250347
Provider Name (Legal Business Name): KRISTA SHERINIAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTA OSNESS LCSW

II. Dates (important events)

Enumeration Date: 01/13/2007
Last Update Date: 09/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

236 S WASHINGTON ST
NAPERVILLE IL
60540-5371
US

IV. Provider business mailing address

236 S WASHINGTON ST
NAPERVILLE IL
60540-5371
US

V. Phone/Fax

Practice location:
  • Phone: 630-355-8410
  • Fax: 630-355-8412
Mailing address:
  • Phone: 630-355-8410
  • Fax: 630-355-8412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149009560
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: