Provider Demographics
NPI:1124660576
Name:FRANK, KATHRYN J (LCPC)
Entity type:Individual
Prefix:MISS
First Name:KATHRYN
Middle Name:J
Last Name:FRANK
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2641 W AUGUSTA BLVD APT 3F
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-4584
Mailing Address - Country:US
Mailing Address - Phone:989-708-9839
Mailing Address - Fax:
Practice Address - Street 1:2641 W AUGUSTA BLVD APT 3F
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-4584
Practice Address - Country:US
Practice Address - Phone:989-708-9839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-16
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.012536101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health