Provider Demographics
NPI:1578243630
Name:KROK, KARLI ANNE (LPC)
Entity Type:Individual
Prefix:
First Name:KARLI
Middle Name:ANNE
Last Name:KROK
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 1:3717 S PAULINA ST # 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60609-2045
Mailing Address - Country:US
Mailing Address - Phone:773-317-3713
Mailing Address - Fax:
Practice Address - Street 1:8770 W BRYN MAWR AVE STE 1300
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-3557
Practice Address - Country:US
Practice Address - Phone:312-768-8073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.019221101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor