Provider Demographics
NPI:1215132501
Name:ELMER, KRYSTYNA (LCPC)
Entity type:Individual
Prefix:MRS
First Name:KRYSTYNA
Middle Name:
Last Name:ELMER
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 1:1655 N ARLINGTON HEIGHTS RD
Mailing Address - Street 2:SUITE # 302E
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-3982
Mailing Address - Country:US
Mailing Address - Phone:708-606-0672
Mailing Address - Fax:847-382-6271
Practice Address - Street 1:752 GOLF CT
Practice Address - Street 2:
Practice Address - City:LAKE BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-3869
Practice Address - Country:US
Practice Address - Phone:847-613-5899
Practice Address - Fax:847-382-6271
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2012-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178005031101YP2500X
IL180.007285101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional