Provider Demographics
NPI:1720443955
Name:FLEMING, KATHRYN (LMFT)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:FLEMING
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 N MICHIGAN AVE STE 1005
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-3402
Mailing Address - Country:US
Mailing Address - Phone:312-989-2917
Mailing Address - Fax:877-535-6471
Practice Address - Street 1:30 N MICHIGAN AVE STE 1005
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-3402
Practice Address - Country:US
Practice Address - Phone:312-989-2917
Practice Address - Fax:877-535-6471
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL166001039106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist