Provider Demographics
NPI:1649815754
Name:BUCK, KARLA ALAINE CIOMBOR (NCC, LCPC, CADC, CGP)
Entity type:Individual
Prefix:MRS
First Name:KARLA
Middle Name:ALAINE CIOMBOR
Last Name:BUCK
Suffix:
Gender:F
Credentials:NCC, LCPC, CADC, CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2640 WOODMERE DR
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:IL
Mailing Address - Zip Code:60561-1503
Mailing Address - Country:US
Mailing Address - Phone:630-640-5268
Mailing Address - Fax:
Practice Address - Street 1:5120 MAIN ST STE 103
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-4667
Practice Address - Country:US
Practice Address - Phone:630-286-9320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-12
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.012306101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional