Provider Demographics
NPI:1184412827
Name:KC COUNSELING, LLC
Entity type:Organization
Organization Name:KC COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KAITLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:CORNELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, CEDS-S
Authorized Official - Phone:217-621-0766
Mailing Address - Street 1:203 FLORA DR
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61821-3212
Mailing Address - Country:US
Mailing Address - Phone:217-621-0766
Mailing Address - Fax:
Practice Address - Street 1:313 N MATTIS AVE STE 209
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61821-2461
Practice Address - Country:US
Practice Address - Phone:217-621-0766
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KC COUNSELING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty