Provider Demographics
NPI:1679039481
Name:LECHNER, KIMBERLY MELTON (PHD, LCPC, NCC)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:MELTON
Last Name:LECHNER
Suffix:
Gender:F
Credentials:PHD, LCPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:376 HILL AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN ELLYN
Mailing Address - State:IL
Mailing Address - Zip Code:60137-4904
Mailing Address - Country:US
Mailing Address - Phone:630-660-6638
Mailing Address - Fax:
Practice Address - Street 1:319 S NAPERVILLE RD STE 203
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-5462
Practice Address - Country:US
Practice Address - Phone:630-660-6638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-17
Last Update Date:2019-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TS0200X
IL180.012050101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool