Individual
MS. KATHRYN A MOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., L.C.P.C.
Contact information
Practice address
6240 N MAGNOLIA AVE APT 1, CHICAGO, IL 60660-1909
(773) 643-1140
Mailing address
6240 N MAGNOLIA AVE APT 1, CHICAGO, IL 60660-1909
(773) 643-1140
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
180-003652
IL
101YM0800X
Mental Health Counselor
180-003652
IL
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
180-003652
IL
Other
Enumeration date
05/01/2006
Last updated
05/21/2024
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