Provider Demographics
NPI:1821247180
Name:FLESVIG, KATRINA MARY (LCPC)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:MARY
Last Name:FLESVIG
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:KATRINA
Other - Middle Name:MARY
Other - Last Name:DRUMMOND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1001 ROHLWING RD
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE VILLAGE
Mailing Address - State:IL
Mailing Address - Zip Code:60007-3217
Mailing Address - Country:US
Mailing Address - Phone:847-524-8800
Mailing Address - Fax:847-524-8824
Practice Address - Street 1:925 WINSLOW CIR
Practice Address - Street 2:
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-3776
Practice Address - Country:US
Practice Address - Phone:847-986-5921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-11
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
IL180008204101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health