Provider Demographics
NPI:1487442901
Name:RASMUSON, ABIGAIL L (LSW)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:L
Last Name:RASMUSON
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:L
Other - Last Name:KOCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6615 N BIG HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61615-2450
Mailing Address - Country:US
Mailing Address - Phone:309-692-6622
Mailing Address - Fax:309-692-6952
Practice Address - Street 1:6615 N BIG HOLLOW RD
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61615-2450
Practice Address - Country:US
Practice Address - Phone:309-692-6622
Practice Address - Fax:309-692-6952
Is Sole Proprietor?:No
Enumeration Date:2025-04-25
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150115802104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker