Healthcare Provider Details

I. General information

NPI: 1518682913
Provider Name (Legal Business Name): KATRINA MARIE ROBINETTE LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2022
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41W400 SILVER GLEN RD
SAINT CHARLES IL
60175-8453
US

IV. Provider business mailing address

1855 ROHLWING RD STE A
ROLLING MEADOWS IL
60008-1474
US

V. Phone/Fax

Practice location:
  • Phone: 331-901-4225
  • Fax:
Mailing address:
  • Phone: 847-390-4503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number150108383
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number150108383
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: