Provider Demographics
NPI:1912253659
Name:BARKUS, KIM (LCPC, CADC)
Entity type:Individual
Prefix:
First Name:KIM
Middle Name:
Last Name:BARKUS
Suffix:
Gender:F
Credentials:LCPC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 N GREENLEAF ST STE 120
Mailing Address - Street 2:
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-3334
Mailing Address - Country:US
Mailing Address - Phone:224-285-0728
Mailing Address - Fax:224-249-4411
Practice Address - Street 1:135 N GREENLEAF ST STE 120
Practice Address - Street 2:
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-3334
Practice Address - Country:US
Practice Address - Phone:224-285-0728
Practice Address - Fax:224-249-4411
Is Sole Proprietor?:No
Enumeration Date:2012-07-31
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
IL180013393101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)