Provider Demographics
NPI:1891481362
Name:YOUNGER, CHRISTA (LSW)
Entity Type:Individual
Prefix:
First Name:CHRISTA
Middle Name:
Last Name:YOUNGER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:MRS
Other - First Name:CHRISTA
Other - Middle Name:
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:371 INDIANWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:PARK FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60466-2363
Mailing Address - Country:US
Mailing Address - Phone:773-507-1593
Mailing Address - Fax:
Practice Address - Street 1:593 BURNHAM AVE
Practice Address - Street 2:
Practice Address - City:CALUMET CITY
Practice Address - State:IL
Practice Address - Zip Code:60409-4031
Practice Address - Country:US
Practice Address - Phone:708-832-1002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.107162104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker