Provider Demographics
NPI:1851087175
Name:BOORAS, KATHERINE ELIZABETH (NCC, LCPC, MA, BS)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:ELIZABETH
Last Name:BOORAS
Suffix:
Gender:F
Credentials:NCC, LCPC, MA, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:872 S MILWAUKEE AVE # 182
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-3227
Mailing Address - Country:US
Mailing Address - Phone:224-378-4240
Mailing Address - Fax:
Practice Address - Street 1:872 S MILWAUKEE AVE # 182
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-3227
Practice Address - Country:US
Practice Address - Phone:847-373-0941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-12
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.016456101YP2500X
IL178.018037101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty