Provider Demographics
NPI:1982211702
Name:CURTIS, KIMBERLY A (LCPC)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:A
Last Name:CURTIS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1616 N DAMEN AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-5536
Mailing Address - Country:US
Mailing Address - Phone:888-428-7890
Mailing Address - Fax:888-428-7891
Practice Address - Street 1:1616 N DAMEN AVE STE 301
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-5536
Practice Address - Country:US
Practice Address - Phone:888-428-7890
Practice Address - Fax:888-428-7891
Is Sole Proprietor?:No
Enumeration Date:2020-09-25
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.016303101Y00000X
IL180.0016631101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor