Provider Demographics
NPI:1285278879
Name:STRATTON, KENNETH (LCPC)
Entity type:Individual
Prefix:
First Name:KENNETH
Middle Name:
Last Name:STRATTON
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5035 S EAST END AVE APT 3205N
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-0130
Mailing Address - Country:US
Mailing Address - Phone:217-416-1826
Mailing Address - Fax:
Practice Address - Street 1:5035 S EAST END AVE APT 3205N
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60615-0130
Practice Address - Country:US
Practice Address - Phone:217-416-1826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-06
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.012543101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional