Provider Demographics
NPI:1952535312
Name:PATTEN, KRISTIN EVELYN (MA, LCPC)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:EVELYN
Last Name:PATTEN
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:EVELYN
Other - Last Name:WEIMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:495 N RIVERSIDE DR STE 208
Mailing Address - Street 2:
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-5920
Mailing Address - Country:US
Mailing Address - Phone:224-208-5228
Mailing Address - Fax:
Practice Address - Street 1:495 N RIVERSIDE DR STE 208
Practice Address - Street 2:
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031
Practice Address - Country:US
Practice Address - Phone:224-208-5228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-13
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180008172101YM0800X, 101YP2500X
IL178005884101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor