Provider Demographics
NPI:1902348592
Name:RAATJES, KRISTA (LCSW)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:
Last Name:RAATJES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KRISTA
Other - Middle Name:
Other - Last Name:BRADT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:9200 W 191ST ST STE 6
Mailing Address - Street 2:
Mailing Address - City:MOKENA
Mailing Address - State:IL
Mailing Address - Zip Code:60448-8730
Mailing Address - Country:US
Mailing Address - Phone:815-421-9131
Mailing Address - Fax:
Practice Address - Street 1:9200 W 191ST ST STE 6
Practice Address - Street 2:
Practice Address - City:MOKENA
Practice Address - State:IL
Practice Address - Zip Code:60448-8730
Practice Address - Country:US
Practice Address - Phone:815-421-9131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-14
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490155791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical