Healthcare Provider Details

I. General information

NPI: 1316787591
Provider Name (Legal Business Name): KATE ALEXANDRA GAVIN MS, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2024
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 N RIVER RD STE 108
NAPERVILLE IL
60563-8947
US

IV. Provider business mailing address

1125 W VAN BUREN ST APT 1811
CHICAGO IL
60607-0051
US

V. Phone/Fax

Practice location:
  • Phone: 630-718-0717
  • Fax: 630-718-0747
Mailing address:
  • Phone: 630-818-7049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: