Provider Demographics
NPI:1790339083
Name:BAHNICK, PATRICIA KAPS (LPC)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:KAPS
Last Name:BAHNICK
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 1:715 E GOLF RD STE 200A5B
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4595
Mailing Address - Country:US
Mailing Address - Phone:847-857-7811
Mailing Address - Fax:
Practice Address - Street 1:715 E GOLF RD STE 200A5B
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4595
Practice Address - Country:US
Practice Address - Phone:847-857-7811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-25
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178014995101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional