Provider Demographics
NPI:1891232328
Name:KACHMAN, KYLA (LCSW)
Entity Type:Individual
Prefix:
First Name:KYLA
Middle Name:
Last Name:KACHMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 DAVIS ST STE 160
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-3664
Mailing Address - Country:US
Mailing Address - Phone:847-425-6400
Mailing Address - Fax:847-425-6408
Practice Address - Street 1:909 DAVIS ST STE 160
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-3664
Practice Address - Country:US
Practice Address - Phone:847-425-6400
Practice Address - Fax:847-425-6408
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-23
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490183591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical