Provider Demographics
NPI:1841055001
Name:EIDT, KATHERYN ALLBEE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:KATHERYN
Middle Name:ALLBEE
Last Name:EIDT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:293 TAYLOR AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN ELLYN
Mailing Address - State:IL
Mailing Address - Zip Code:60137-5230
Mailing Address - Country:US
Mailing Address - Phone:314-640-5157
Mailing Address - Fax:
Practice Address - Street 1:293 TAYLOR AVE
Practice Address - Street 2:
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-5230
Practice Address - Country:US
Practice Address - Phone:314-640-5157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-16
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.01929091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical