Healthcare Provider Details

I. General information

NPI: 1023981271
Provider Name (Legal Business Name): CHRISTOPHER TREY SEXTON LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2025
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4409 MAINE ST
QUINCY IL
62305-5849
US

IV. Provider business mailing address

PO BOX 3646
QUINCY IL
62305-3646
US

V. Phone/Fax

Practice location:
  • Phone: 217-223-0423
  • Fax: 217-223-0461
Mailing address:
  • Phone: 217-223-0423
  • Fax: 217-223-0461

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149030179
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: