Provider Demographics
NPI:1710371695
Name:KUEHNE, KIMBERLIE (LCPC)
Entity Type:Individual
Prefix:
First Name:KIMBERLIE
Middle Name:
Last Name:KUEHNE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3132 W NORTH AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-8410
Mailing Address - Country:US
Mailing Address - Phone:630-605-5294
Mailing Address - Fax:
Practice Address - Street 1:3132 W NORTH AVE APT 3
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-8410
Practice Address - Country:US
Practice Address - Phone:630-605-5294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-27
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180011047101YP2500X
IL178009473101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health