Kathleen S. Baxa, MS, LPC
Individual provider Active NPI Professional Counselor · Dekalb, IL
NPI 1851677504 · NPPES record last updated Oct 26, 2011
Key facts
- NPI
- 1851677504
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 178007469 (IL)
- Practice address
- 12 Health Services Dr
Dekalb, IL 60115-9637 - Phone
- (815) 756-4875
- NPI assigned
- Oct 26, 2011
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178007469 | IL | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 178007469 | IL | Yes |
Addresses
Primary practice location
12 Health Services Dr
Dekalb, IL 60115-9637
Mailing address
12 Health Services Dr
Dekalb, IL 60115-9637
Phone (815) 756-4875
Other providers in Dekalb, IL
- Ami S Barot
- Todd R Barrowclift
- Justin Bartlett
- Lynn T Batalden
- Joseph R Baumgart
- Maya Beard
- Melissa Rhoades Beck
- Lisa Davidson Becker
- Kathleen Marie Becket
- Emily Belcher
All providers in Dekalb, 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 26, 2011. 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.