Individual
CHRISTINE CUSACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, BCBA
Contact information
Practice address
422 S MAIN ST UNIT 2040, LOMBARD, IL 60148-2600
(630) 791-0995
Mailing address
2105 S FINLEY RD APT 112, LOMBARD, IL 60148-6451
(312) 859-5357
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-22-58906
IL
1041C0700X
Clinical Social Worker
Primary
149.018421
IL
Other
Enumeration date
05/03/2024
Last updated
05/03/2024
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