Provider Demographics
NPI:1528826013
Name:ABERNATHY, KALEA (LPC)
Entity type:Individual
Prefix:
First Name:KALEA
Middle Name:
Last Name:ABERNATHY
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 1:1122 RODRIQUEZ CT
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-3828
Mailing Address - Country:US
Mailing Address - Phone:720-556-2860
Mailing Address - Fax:
Practice Address - Street 1:945 W GEORGE ST STE 206
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-5876
Practice Address - Country:US
Practice Address - Phone:773-360-1687
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-08
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.019966101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor