Provider Demographics
NPI:1891353264
Name:WESTERGAARD, CHRISTOPHER JAY (MSW, LGSW)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:JAY
Last Name:WESTERGAARD
Suffix:
Gender:M
Credentials:MSW, LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2312 SNELLING AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-3157
Mailing Address - Country:US
Mailing Address - Phone:612-874-6409
Mailing Address - Fax:
Practice Address - Street 1:2312 SNELLING AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-3157
Practice Address - Country:US
Practice Address - Phone:612-874-6409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-31
Last Update Date:2019-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN27638104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker