Provider Demographics
NPI:1184947442
Name:EDWARDS, KIRSTEN M (LCSW)
Entity type:Individual
Prefix:MS
First Name:KIRSTEN
Middle Name:M
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:KIRSTEN
Other - Middle Name:M
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2500 W HIGGINS RD STE 1133
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-7239
Mailing Address - Country:US
Mailing Address - Phone:847-805-8800
Mailing Address - Fax:
Practice Address - Street 1:2500 W HIGGINS RD STE 1133
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-7239
Practice Address - Country:US
Practice Address - Phone:847-805-8800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-01
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0135721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical