Provider Demographics
NPI:1699511832
Name:LIFEPOINT CHILD THERAPY LTD
Entity type:Organization
Organization Name:LIFEPOINT CHILD THERAPY LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:E
Authorized Official - Last Name:PATTEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:224-715-0328
Mailing Address - Street 1:18765 W WESTWOOD PL
Mailing Address - Street 2:
Mailing Address - City:LAKE VILLA
Mailing Address - State:IL
Mailing Address - Zip Code:60046-7432
Mailing Address - Country:US
Mailing Address - Phone:224-715-0328
Mailing Address - Fax:
Practice Address - Street 1:5101 WASHINGTON ST
Practice Address - Street 2:STE 1108
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031
Practice Address - Country:US
Practice Address - Phone:224-208-5228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty