Provider Demographics
NPI:1295492288
Name:KROUSE, EMILY (LPC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:KROUSE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:349 CASCADE LN
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:IL
Mailing Address - Zip Code:60543-7337
Mailing Address - Country:US
Mailing Address - Phone:630-608-7054
Mailing Address - Fax:
Practice Address - Street 1:311 N 2ND ST STE 207
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-1852
Practice Address - Country:US
Practice Address - Phone:630-797-9192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-24
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.017633101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor