Kristina M Walz, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

178019875 Issued in IL

Practice address

3111 W Armitage Ave Ste 203
Chicago, IL 60647-3818

Phone

(847) 650-4044

NPI assigned

Sep 24, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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": "1727136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1568289296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3012 W LYNDALE ST UNIT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472812",
            "telephone_number": "847-650-4044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3111 W ARMITAGE AVE STE 203",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606473818",
            "telephone_number": "847-650-4044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALZ",
        "first_name": "KRISTINA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-24",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "38250",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178019875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "securerecords.sanford.html",
            "affiliation": "Y",
            "affiliationName": "Chicago Therapy Working Group, LLC",
            "address_1": "3111 W Armitage Ave Ste 203",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606473818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jesse Patrick Waltz, MAED, LMFT
• Ellen R Walukas, DNP
• Marianne Eve Walwema
• Elizabeth Walz-Buscher, M.D
• Amy Leanne Walz, M.D.
• Caroline G Wambach, MD
• Merriam Elizabeth Wamble, MS, LCPC, RDDP
• Jenny Marie Wamsat, PSY.D.
• Regina Wan, MSN, NNP-BC
• Vivian Wan

• 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 Sep 24, 2024; 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.