Provider Demographics
NPI:1548032022
Name:WEISSBURG, KELSEY (LSW)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:WEISSBURG
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 N MICHIGAN AVE STE 704
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-3905
Mailing Address - Country:US
Mailing Address - Phone:312-715-8234
Mailing Address - Fax:
Practice Address - Street 1:333 N MICHIGAN AVE STE 704
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-3905
Practice Address - Country:US
Practice Address - Phone:312-715-8234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-26
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker