Provider Demographics
NPI:1578636015
Name:MCKELVIN, KRISTA DELANEY (LPC)
Entity Type:Individual
Prefix:MRS
First Name:KRISTA
Middle Name:DELANEY
Last Name:MCKELVIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:175 E HAWTHORN PKWY STE 235
Mailing Address - Street 2:
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1454
Mailing Address - Country:US
Mailing Address - Phone:847-737-8768
Mailing Address - Fax:847-859-5885
Practice Address - Street 1:11551 FOREST CENTRAL DR STE 202
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-3919
Practice Address - Country:US
Practice Address - Phone:817-751-7802
Practice Address - Fax:847-859-5885
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2019-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4103101YM0800X
TX81766101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health