Provider Demographics
NPI:1790210490
Name:BIERTON, SKYE (LCSW)
Entity Type:Individual
Prefix:
First Name:SKYE
Middle Name:
Last Name:BIERTON
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 1:418 S ELMWOOD AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-4972
Mailing Address - Country:US
Mailing Address - Phone:585-944-8330
Mailing Address - Fax:
Practice Address - Street 1:418 S ELMWOOD AVE APT 2
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-4972
Practice Address - Country:US
Practice Address - Phone:585-944-8330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-01
Last Update Date:2022-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490230201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical