Provider Demographics
NPI:1619332129
Name:MUKHERJI, KARISHMA (LPC)
Entity Type:Individual
Prefix:
First Name:KARISHMA
Middle Name:
Last Name:MUKHERJI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KARISHMA
Other - Middle Name:
Other - Last Name:TALREJA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:70 E LAKE ST
Mailing Address - Street 2:STE. 222
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-5959
Mailing Address - Country:US
Mailing Address - Phone:630-309-2044
Mailing Address - Fax:
Practice Address - Street 1:70 E LAKE ST
Practice Address - Street 2:STE. 222
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-5959
Practice Address - Country:US
Practice Address - Phone:630-309-2044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-28
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.011590101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health