Provider Demographics
NPI:1821146143
Name:MIKOLITE, KRISTIN MARGARET (LCPC, CADC)
Entity Type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:MARGARET
Last Name:MIKOLITE
Suffix:
Gender:F
Credentials:LCPC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7300 W COLLEGE DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-1152
Mailing Address - Country:US
Mailing Address - Phone:708-448-0884
Mailing Address - Fax:708-448-0594
Practice Address - Street 1:7300 W COLLEGE DR
Practice Address - Street 2:SUITE 203
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1152
Practice Address - Country:US
Practice Address - Phone:708-448-0884
Practice Address - Fax:708-448-0594
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL6446101YA0400X
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional