Healthcare Provider Details

I. General information

NPI: 1811827231
Provider Name (Legal Business Name): KARINNA VELTZE LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5350 S PRAIRIE AVE
CHICAGO IL
60615-4709
US

IV. Provider business mailing address

6233 S WOODLAWN AVE # 3
CHICAGO IL
60637-6710
US

V. Phone/Fax

Practice location:
  • Phone: 217-292-6432
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number150.119211
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: