Waller, Fiona Christine
Waller, Fiona Christine is an individual health care provider with primary practice located at 145 Morris Ln Unit 108 , Lake Forest IL 60045-1389. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Waller, Fiona Christine can be contacted via phone (630) 596-7359.Contact Information
Primary practice address
145 Morris Ln Unit 108
Lake Forest IL 60045-1389
Phone: (630) 596-7359
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Social Worker | 104100000X | 2020013516 | Missouri |
Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 2022029180 | Missouri |
Profile Details
NPI number | 1710552203 |
---|---|
LBN Legal business name | Waller, Fiona Christine |
Credentials | Licensed Clinical Social Worker (LCSW) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | May 26th, 2021 |
Last updated | Jan 23rd, 2024 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1710552203 | NPPES |
Missouri | Other | 2020013516 | SOCIAL WORK LICENSE |
Missouri | Other | 2022029180 | SOCIAL WORK LICENSE |
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