Healthcare Provider Details

I. General information

NPI: 1770204224
Provider Name (Legal Business Name): KEVIN CHARLES BARTON LCPC, NCC, CMPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2022
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1952 MCDOWELL RD. STE 305
NAPERVILLE IL
60563
US

IV. Provider business mailing address

2 MARDIS CT
TROY IL
62294-1835
US

V. Phone/Fax

Practice location:
  • Phone: 630-689-1022
  • Fax:
Mailing address:
  • Phone: 618-581-8767
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180018066
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: