Provider Demographics
NPI:1205041837
Name:ERLAND, KRISTINA ELIZABETH (LCSW)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:ELIZABETH
Last Name:ERLAND
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5227 N GLENWOOD AVE UNIT 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-2216
Mailing Address - Country:US
Mailing Address - Phone:773-339-5848
Mailing Address - Fax:847-589-2914
Practice Address - Street 1:1603 ORRINGTON AVE STE 600
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-3860
Practice Address - Country:US
Practice Address - Phone:847-859-9553
Practice Address - Fax:847-589-2914
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490130451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical