Provider Demographics
NPI:1306065776
Name:OSTRANDER, NOMI (PHD, LCSW, LICSW)
Entity type:Individual
Prefix:
First Name:NOMI
Middle Name:
Last Name:OSTRANDER
Suffix:
Gender:F
Credentials:PHD, LCSW, LICSW
Other - Prefix:
Other - First Name:NOAM
Other - Middle Name:
Other - Last Name:OSTRANDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1132 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55805-2212
Mailing Address - Country:US
Mailing Address - Phone:773-573-7833
Mailing Address - Fax:
Practice Address - Street 1:4305 N LINCOLN AVE
Practice Address - Street 2:SUITE K
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-1711
Practice Address - Country:US
Practice Address - Phone:773-573-7783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
IL149.0107571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical