Provider Demographics
NPI:1316720741
Name:HUGGINS, KIMESHA LYNETTE (LPC)
Entity type:Individual
Prefix:
First Name:KIMESHA
Middle Name:LYNETTE
Last Name:HUGGINS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6923 S PRAIRIE AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60637-6542
Mailing Address - Country:US
Mailing Address - Phone:773-750-4271
Mailing Address - Fax:
Practice Address - Street 1:6923 S PRAIRIE AVE APT 3
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-6542
Practice Address - Country:US
Practice Address - Phone:773-750-4271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.011268101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor