Healthcare Provider Details

I. General information

NPI: 1336736552
Provider Name (Legal Business Name): KATHERINE DAVIS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2020
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 W HIGGINS RD STE 505
HOFFMAN ESTATES IL
60169-2045
US

IV. Provider business mailing address

2500 W HIGGINS RD STE 505
HOFFMAN ESTATES IL
60169-2045
US

V. Phone/Fax

Practice location:
  • Phone: 224-801-4333
  • Fax:
Mailing address:
  • Phone: 847-627-9022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number178018184
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: