MEDICARE: MRS. KATHERINE ELYSE ALBAVERA LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	149.030015	IL

General Provider Information

NPI Number	:	1336008721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KATHERINE ELYSE ALBAVERA LCSW

Provider Business Mailing Address
First Line	:	3919 TWIN OAKS DR
Second Line	:
City	:	WONDER LAKE
State	:	IL
Zip	:	60097-8154
Country	:	US
Telephone Number	:	815-575-8006
Fax Number	:

Provider Business Practice Location Address
First Line	:	9 CRYSTAL LAKE RD STE 140
Second Line	:
City	:	LAKE IN THE HILLS
State	:	IL
Zip	:	60156-1254
Country	:	US
Telephone Number	:	815-575-8006
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/20/2026
Last Update Date	:	01/20/2026

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