Provider Demographics
NPI:1912366592
Name:AHLIN, CATHERINE (LPC, LCPC)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:AHLIN
Suffix:
Gender:F
Credentials:LPC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 N LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:JERSEYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62052-1021
Mailing Address - Country:US
Mailing Address - Phone:314-602-9712
Mailing Address - Fax:
Practice Address - Street 1:909 N LIBERTY ST
Practice Address - Street 2:
Practice Address - City:JERSEYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62052-1021
Practice Address - Country:US
Practice Address - Phone:314-602-9712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-11
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.011040101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health