Provider Demographics
NPI:1104881275
Name:SLIWICKI, KRISTIN HALL (LCPC, LMFT)
Entity type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:HALL
Last Name:SLIWICKI
Suffix:
Gender:F
Credentials:LCPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1580 S MILWAUKEE AVE STE 504
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-3776
Mailing Address - Country:US
Mailing Address - Phone:847-567-1448
Mailing Address - Fax:
Practice Address - Street 1:1580 S MILWAUKEE AVE STE 504
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-3776
Practice Address - Country:US
Practice Address - Phone:847-567-1448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-004009101YP2500X
IL166-000660106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional