Provider Demographics
NPI:1801411665
Name:MUELLER, KATLHEEN NORA (MA, CRC, LCPC, CEAS)
Entity Type:Individual
Prefix:MS
First Name:KATLHEEN
Middle Name:NORA
Last Name:MUELLER
Suffix:
Gender:F
Credentials:MA, CRC, LCPC, CEAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 E DIEHL RD
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-1458
Mailing Address - Country:US
Mailing Address - Phone:630-248-7886
Mailing Address - Fax:
Practice Address - Street 1:1120 E DIEHL RD
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-1458
Practice Address - Country:US
Practice Address - Phone:630-248-7886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-08
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.009222101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health