Healthcare Provider Details

I. General information

NPI: 1295030146
Provider Name (Legal Business Name): KRYSTINA M STARKEY LCSW, CADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KRYSTINA M FREEHILL

II. Dates (important events)

Enumeration Date: 01/24/2011
Last Update Date: 05/23/2022
Certification Date: 05/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4320 WINFIELD RD STE 200
WARRENVILLE IL
60555-4023
US

IV. Provider business mailing address

4320 WINFIELD RD STE 200
WARRENVILLE IL
60555-4023
US

V. Phone/Fax

Practice location:
  • Phone: 815-303-3797
  • Fax:
Mailing address:
  • Phone: 815-303-3797
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number34573
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.022895
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: