Provider Demographics
NPI:1164126736
Name:DIPRE, KIRSIS ALLENNYS (LPC, NCC)
Entity Type:Individual
Prefix:DR
First Name:KIRSIS
Middle Name:ALLENNYS
Last Name:DIPRE
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 HOWARD ST APT 502
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-4047
Mailing Address - Country:US
Mailing Address - Phone:847-260-8067
Mailing Address - Fax:
Practice Address - Street 1:415 HOWARD ST APT 502
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-4047
Practice Address - Country:US
Practice Address - Phone:847-260-8067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-28
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.018597101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional