Provider Demographics
NPI:1720315773
Name:LOWER, KATHERINE JONESCO (LCPC, BC-DMT)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:JONESCO
Last Name:LOWER
Suffix:
Gender:F
Credentials:LCPC, BC-DMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3141 N SEMINARY AVE
Mailing Address - Street 2:3
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-3308
Mailing Address - Country:US
Mailing Address - Phone:773-558-7237
Mailing Address - Fax:
Practice Address - Street 1:3020 N LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-4208
Practice Address - Country:US
Practice Address - Phone:773-281-8130
Practice Address - Fax:773-281-7150
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-12
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225600000X
IL180.008238101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No225600000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDance Therapist