Provider Demographics
NPI:1104290006
Name:LANTZ, KALYN (MA)
Entity type:Individual
Prefix:
First Name:KALYN
Middle Name:
Last Name:LANTZ
Suffix:
Gender:
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5514 W LAWRENCE AVE STE A
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630-3412
Mailing Address - Country:US
Mailing Address - Phone:872-248-4344
Mailing Address - Fax:
Practice Address - Street 1:5514 W LAWRENCE AVE STE A
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630-3412
Practice Address - Country:US
Practice Address - Phone:872-248-4344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-17
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor