Ms. Kelly Lynne Canavan
Mental Health Counselor
800 S Mchenry Ave
Crystal Lake
, Illinois 60014-7487
Ms. Kelly Lynne Canavan
Mental Health Counselor
800 S Mchenry Ave
Crystal Lake
, Illinois 60014-7487
(815) 979-2580
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About
Features
Specialties
- Mental Health Counselor
Languages spoken
- English
Location
First Address
- Ms. Kelly Lynne Canavan
- 800 S Mchenry Ave
- Crystal Lake, IL
- Zip : 60014-7487
- Phone : (815) 979-2580
Second Address
- Ms. Kelly Lynne Canavan
- 800 S Mchenry Ave
- Crystal Lake, IL
- Zip : 60014-7487
- Phone : (815) 979-2580
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 101YM0800X | Mental Health Counselor | 180.009124 | IL |
National Provider Identifier
| NPI | 1003221045 |
|---|---|
| Provider Name | Ms. Kelly Lynne Canavan |
| First Address | Crystal Lake, IL 60014-7487 |
| Second Address | Crystal Lake, IL 60014-7487 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 28/06/2014 |
| Last Update Date | 28/06/2014 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.