Healthcare Provider Details

I. General information

NPI: 1679499537
Provider Name (Legal Business Name): KATE BIRLINGMAIR LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1002 CHURCHILL RD STE 1
MAHOMET IL
61853-7456
US

IV. Provider business mailing address

1002 CHURCHILL RD STE 1
MAHOMET IL
61853-7456
US

V. Phone/Fax

Practice location:
  • Phone: 217-655-4993
  • Fax: 217-655-4726
Mailing address:
  • Phone: 217-655-4993
  • Fax: 217-655-4726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: