Provider Demographics
NPI:1568820298
Name:KHARA, KAVITA B (LCPC)
Entity Type:Individual
Prefix:
First Name:KAVITA
Middle Name:B
Last Name:KHARA
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 1:917 W WASHINGTON BLVD
Mailing Address - Street 2:SUITE #113
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-2203
Mailing Address - Country:US
Mailing Address - Phone:815-418-6070
Mailing Address - Fax:779-803-0169
Practice Address - Street 1:917 W WASHINGTON BLVD
Practice Address - Street 2:SUITE #113
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-2203
Practice Address - Country:US
Practice Address - Phone:815-418-6070
Practice Address - Fax:779-803-0169
Is Sole Proprietor?:No
Enumeration Date:2016-02-09
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional