Provider Demographics
NPI:1003074022
Name:EVANS, KATE S (LCPC)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:S
Last Name:EVANS
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 1:847 S RANDALL RD # 189
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-3002
Mailing Address - Country:US
Mailing Address - Phone:224-795-1712
Mailing Address - Fax:
Practice Address - Street 1:1420 RIDGE RD
Practice Address - Street 2:
Practice Address - City:SOUTH ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60177-3005
Practice Address - Country:US
Practice Address - Phone:224-795-1712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-27
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.006508101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor