Provider Demographics
NPI:1154409522
Name:VOORHEES, KELLY K (LCPC)
Entity type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:K
Last Name:VOORHEES
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 1:12604 S CHERRY BLOSSOM BLVD
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60585-2316
Mailing Address - Country:US
Mailing Address - Phone:630-234-8776
Mailing Address - Fax:
Practice Address - Street 1:24012 W MAIN ST STE 106
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-2227
Practice Address - Country:US
Practice Address - Phone:815-648-8083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180005796101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL562478620OtherTAX ID