Provider Demographics
NPI:1114127727
Name:MADDEN, KATHERINE IRENE (MA,LPC)
Entity Type:Individual
Prefix:MISS
First Name:KATHERINE
Middle Name:IRENE
Last Name:MADDEN
Suffix:
Gender:F
Credentials:MA,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9728 S LAWNDALE AVE
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60805-2907
Mailing Address - Country:US
Mailing Address - Phone:708-655-6721
Mailing Address - Fax:
Practice Address - Street 1:307 N MICHIGAN AVE STE 1008
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-5310
Practice Address - Country:US
Practice Address - Phone:312-343-1967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-21
Last Update Date:2007-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional