Provider Demographics
NPI:1649739152
Name:LIFEPOINT CHILD & FAMILY THERAPY LTD
Entity Type:Organization
Organization Name:LIFEPOINT CHILD & FAMILY THERAPY LTD
Other - Org Name:LIFEPOINT CHILD & FAMILY THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:E
Authorized Official - Last Name:PATTEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:224-208-5228
Mailing Address - Street 1:1870 W WINCHESTER RD STE 203
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-5360
Mailing Address - Country:US
Mailing Address - Phone:224-208-5228
Mailing Address - Fax:
Practice Address - Street 1:1870 W WINCHESTER RD STE 203
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-5360
Practice Address - Country:US
Practice Address - Phone:224-208-5228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-14
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty