Katherine Goelitz, LCPC
Individual provider Active NPI Professional Counselor · Broadview, IL
NPI 1124475405 · NPPES record last updated Oct 19, 2016
Key facts
- NPI
- 1124475405
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 180008392 (IL)
- Practice address
- 1915 W Roosevelt Rd
Broadview, IL 60155-2925 - Phone
- (708) 498-0200
- NPI assigned
- May 17, 2016
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180008392 | IL | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 180008392 | IL | Yes |
Addresses
Primary practice location
1915 W Roosevelt Rd
Broadview, IL 60155-2925
Mailing address
1028 N Paulina St
Chicago, IL 60622-3857
Phone (708) 878-9530
Other providers in Broadview, IL
- Tara Ann Farmer
- FMR Home Health Inc
- Michael J Fonda
- For Eyes Optical of PA
- Brandy K Fountain
- Nadia Gomez-Moran
- Gabriela Gonet
- Michelle Gosa
- Lauren Marie Hansen
- Lazerric Allen Hartzog
All providers in Broadview, IL · Professional Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 19, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.