Provider Demographics
NPI:1942467832
Name:KRUG, WHITNEY LYNN (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:WHITNEY
Middle Name:LYNN
Last Name:KRUG
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:346 TAFT AVE
Mailing Address - Street 2:#30
Mailing Address - City:GLEN ELLYN
Mailing Address - State:IL
Mailing Address - Zip Code:60137-6296
Mailing Address - Country:US
Mailing Address - Phone:630-690-3170
Mailing Address - Fax:
Practice Address - Street 1:346 TAFT AVE
Practice Address - Street 2:#30
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-6296
Practice Address - Country:US
Practice Address - Phone:630-690-3170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.005196101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional