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Organization
KELLY KAZUKAUSKAS CLINICAL PROFESSIONAL COUNSELING, LLC
Active
Organization
KELLY KAZUKAUSKAS CLINICAL PROFESSIONAL COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY KAZUKAUSKAS PH.D., LCPC, CRC (OWNER)
(312) 933-1162
Entity
Organization
Contact information
Practice address
3105 S DEARBORN ST STE 246A, CHICAGO, IL 60616-2852
(312) 567-3506
Mailing address
13602 S TARA DR, HOMER GLEN, IL 60491-9172
(312) 933-1162
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
180.008591
IL
101YP2500X
Professional Counselor
Primary
180.008591
IL
Other
Enumeration date
04/07/2015
Last updated
04/07/2015
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