Provider Demographics
NPI:1417493495
Name:KETT COUNSELING AND EDUCATIONAL SERVICES, LLC
Entity Type:Organization
Organization Name:KETT COUNSELING AND EDUCATIONAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:KETT
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:312-800-9426
Mailing Address - Street 1:PO BOX 1464
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-8464
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4300 COMMERCE CT
Practice Address - Street 2:STE 220
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-3709
Practice Address - Country:US
Practice Address - Phone:312-800-9426
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-13
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180001553251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health