Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | IL | |
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | IL | |
N | 101YM0800X | Mental Health Counselor | ||
N | 101YM0800X | Mental Health Counselor | IL | |
N | 101YP1600X | Pastoral Counselor | IL | |
Y | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | IL | |
N | 103TB0200X | Cognitive & Behavioral Psychologist | IL |
NPI | 1487104204 |
---|---|
Provider Name | Karen White |
First Address | Chicago, IL 60620-5759 |
Second Address | Chicago, IL 60643-2821 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2016 |
Last Update Date | 17/08/2020 |