Provider Demographics
NPI:1972494755
Name:CWIK, KIRSTIN AUTUMN (LSW)
Entity type:Individual
Prefix:
First Name:KIRSTIN
Middle Name:AUTUMN
Last Name:CWIK
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 1:2450 N PLUM GROVE RD UNIT 375
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4756
Mailing Address - Country:US
Mailing Address - Phone:630-991-7416
Mailing Address - Fax:
Practice Address - Street 1:330 W TERRA COTTA AVE STE A
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-3552
Practice Address - Country:US
Practice Address - Phone:815-382-9691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-10
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.1169931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical