Provider Demographics
NPI:1407427974
Name:LOFGREN, KAY FOLEY (MA, LCPC)
Entity Type:Individual
Prefix:
First Name:KAY
Middle Name:FOLEY
Last Name:LOFGREN
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1878 CHANDLER AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-4601
Mailing Address - Country:US
Mailing Address - Phone:630-352-7210
Mailing Address - Fax:
Practice Address - Street 1:1878 CHANDLER AVE
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-4601
Practice Address - Country:US
Practice Address - Phone:630-352-7210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-06
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.011574101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional