Provider Demographics
NPI:1477646347
Name:STROHM, KIRBY STURTEVANT (LCSW)
Entity Type:Individual
Prefix:MR
First Name:KIRBY
Middle Name:STURTEVANT
Last Name:STROHM
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 POTTOWATAMIE CT
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:IL
Mailing Address - Zip Code:60543
Mailing Address - Country:US
Mailing Address - Phone:630-551-3723
Mailing Address - Fax:
Practice Address - Street 1:3033 OGDEN AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532
Practice Address - Country:US
Practice Address - Phone:630-527-1664
Practice Address - Fax:630-983-0162
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
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