Kelly Kazukauskas Clinical Professional Counseling, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180.008591 Issued in IL

Legal business name

KELLY KAZUKAUSKAS CLINICAL PROFESSIONAL COUNSELING, LLC

Practice address

3105 S Dearborn St Ste 246a
Chicago, IL 60616-2852

Phone

(312) 567-3506

NPI assigned

Apr 7, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Kelly Kazukauskas, PH.D., LCPC, CRCNPI 1053588749

Title

Owner

Phone

(312) 933-1162

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kelly A Kazukauskas, PHD, LCPC, CRC, CVE

  • Professional Counselor
  • Chicago, IL
  • NPI 1053588749
  NPD (past) Authorized official

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

{
    "created_epoch": "1428364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428364800000",
    "number": "1831585751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13602 S TARA DR",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "604919172",
            "telephone_number": "312-933-1162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3105 S DEARBORN ST STE 246A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162852",
            "telephone_number": "312-567-3506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY KAZUKAUSKAS CLINICAL PROFESSIONAL COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-07",
        "last_updated": "2015-04-07",
        "status": "A",
        "authorized_official_last_name": "KAZUKAUSKAS",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-933-1162",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D., LCPC, CRC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.008591",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.008591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David James Kellner
• Kelly a Fallon DC LTD
• Kelly Chiropractic and Wellness Center S.C.
• Kelly Chiropractic, Inc.
• Kelly Jones Psy.D.
• Kelly Low
• Kelly Skerrett PC
• Kelly Vierra, LCSW, LLC
• Amanda M Kelly, PHARMD
• Amy Kelly

• 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 Apr 7, 2015; 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.