Healthcare Provider Details

I. General information

NPI: 1659090025
Provider Name (Legal Business Name): TESSA V STERLING LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2022
Last Update Date: 01/02/2025
Certification Date: 01/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15146 16TH AVE
MARNE MI
49435-9605
US

IV. Provider business mailing address

60 REVERE DR STE 100
NORTHBROOK IL
60062-1590
US

V. Phone/Fax

Practice location:
  • Phone: 877-776-9651
  • Fax: 616-341-6016
Mailing address:
  • Phone: 224-306-1879
  • Fax: 224-306-1878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.022363
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: