Provider Demographics
NPI:1417589367
Name:LONDERGAN, KARA (MA, AMFT)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:LONDERGAN
Suffix:
Gender:F
Credentials:MA, AMFT
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:
Other - Last Name:LONDERGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, AMFT
Mailing Address - Street 1:12 E PENNY RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-9572
Mailing Address - Country:US
Mailing Address - Phone:773-914-0082
Mailing Address - Fax:
Practice Address - Street 1:53 W JACKSON BLVD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60604-3606
Practice Address - Country:US
Practice Address - Phone:773-423-8447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-09
Last Update Date:2020-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208.000771106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty