Provider Demographics
NPI:1588140479
Name:KIRSCHNER, STEPHANIE R (LPC)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:R
Last Name:KIRSCHNER
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 1:1848 WEEG WAY
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-1230
Mailing Address - Country:US
Mailing Address - Phone:847-828-4911
Mailing Address - Fax:
Practice Address - Street 1:625 N NORTH CT STE 350
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-8160
Practice Address - Country:US
Practice Address - Phone:224-801-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-14
Last Update Date:2018-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.013791101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional