Provider Demographics
NPI:1407949720
Name:LOCKE, CHRISTIAN ROBERT (LCSW)
Entity Type:Individual
Prefix:MR
First Name:CHRISTIAN
Middle Name:ROBERT
Last Name:LOCKE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:705 N SPARKLE CT
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:IL
Mailing Address - Zip Code:60543-7942
Mailing Address - Country:US
Mailing Address - Phone:630-913-7045
Mailing Address - Fax:630-428-3593
Practice Address - Street 1:800 W 5TH AVE
Practice Address - Street 2:SUITE 205G
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-8965
Practice Address - Country:US
Practice Address - Phone:630-913-7045
Practice Address - Fax:630-428-3593
Is Sole Proprietor?:No
Enumeration Date:2006-09-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical