Kaitlin Blakeney, LPC, CRC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

178.013763 Issued in IL

Practice address

11350 S Langley Ave
Chicago, IL 60628-5126

Phone

(815) 295-7005

NPI assigned

Jun 19, 2018

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1529366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551571200000",
    "number": "1306330766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10260 S BEVERLY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606431382",
            "telephone_number": "815-295-7005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11350 S LANGLEY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606285126",
            "telephone_number": "815-295-7005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1448 N Milwaukee Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606229225",
            "country_code": "US",
            "telephone_number": "815-295-7005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAKENEY",
        "first_name": "KAITLIN",
        "credential": "LPC, CRC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-19",
        "last_updated": "2019-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.013763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Blake, FNP-BC
• Zachary Blake
• Colette Blakely, LCPC
• Kyle Joshua Blakely
• Callie Blakeman, LCSW
• Tierra Diane Blakes
• Stephanie Blakeslee
• Tiffany Sharie Blakey
• Blanca Murillo DDS
• Anita Blanchard, M.D.

• Professional Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.