Provider Demographics
NPI:1225454861
Name:CAIN, KRISTINE (LCPC)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:
Last Name:CAIN
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 1:20550 S LAGRANGE RD STE 210
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-1495
Mailing Address - Country:US
Mailing Address - Phone:708-227-4546
Mailing Address - Fax:
Practice Address - Street 1:20550 S LAGRANGE RD STE 210
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-1495
Practice Address - Country:US
Practice Address - Phone:708-227-4546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-06
Last Update Date:2023-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
IL020006952124Q00000X
IL180.010665101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No124Q00000XDental ProvidersDental Hygienist