Provider Demographics
NPI:1851640874
Name:PADILLA, KRISTY VERONICA (MA, LCPC)
Entity Type:Individual
Prefix:MRS
First Name:KRISTY
Middle Name:VERONICA
Last Name:PADILLA
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:MS
Other - First Name:KRISTY
Other - Middle Name:VERONICA
Other - Last Name:GARZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7937 S HARLEM AVE # 319
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:IL
Mailing Address - Zip Code:60459-1600
Mailing Address - Country:US
Mailing Address - Phone:708-435-9224
Mailing Address - Fax:
Practice Address - Street 1:125 WINDSOR DR
Practice Address - Street 2:113
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1536
Practice Address - Country:US
Practice Address - Phone:708-435-9224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-05
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.008321101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor