Provider Demographics
NPI:1417564261
Name:SCHWAB, KELSEY (LPC)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:SCHWAB
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17568 W HICKORY LN
Mailing Address - Street 2:
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-3026
Mailing Address - Country:US
Mailing Address - Phone:224-730-8714
Mailing Address - Fax:
Practice Address - Street 1:17568 W HICKORY LN
Practice Address - Street 2:
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-3026
Practice Address - Country:US
Practice Address - Phone:224-730-8714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-25
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.016289101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health