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:
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Health care specialties

SpecialtyCodeLicense #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 11 months ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710552203 NPPES
Missouri Other 2020013516 SOCIAL WORK LICENSE
Missouri Other 2022029180 SOCIAL WORK LICENSE

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