Provider Demographics
NPI:1568702546
Name:TABISZ, KATHRYN FRANCES (LCSW)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:FRANCES
Last Name:TABISZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:FRANCES
Other - Last Name:PERSSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25W560 GENEVA RD # 20
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-2233
Mailing Address - Country:US
Mailing Address - Phone:630-557-6567
Mailing Address - Fax:
Practice Address - Street 1:25W560 GENEVA RD # 20
Practice Address - Street 2:
Practice Address - City:CAROL STREAM
Practice Address - State:IL
Practice Address - Zip Code:60188-2233
Practice Address - Country:US
Practice Address - Phone:630-557-6567
Practice Address - Fax:630-557-6567
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-27
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool