Healthcare Provider Details

I. General information

NPI: 1538412242
Provider Name (Legal Business Name): KIRSTEN HOLLY RASMUSSEN LCSW, CADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2012
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29W120 BUTTERFIELD ROAD SUITE 104 A
WARRENVILLE IL
60555
US

IV. Provider business mailing address

114 GREENBAY RD
MOORESVILLE NC
28117-8884
US

V. Phone/Fax

Practice location:
  • Phone: 630-715-4006
  • Fax:
Mailing address:
  • Phone: 630-715-4006
  • Fax: 615-334-0896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number29471
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number27656-C
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW00001441
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.015354
License Number StateIL
# 5
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC013245
License Number StateNC
# 6
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09929823
License Number StateCO
# 7
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC11765
License Number StateMS
# 8
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number2447941
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: