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General NPI Number Information
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NPI Number | 1003590035
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Entity Type | Individual
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Provider Name | KATHRINE BRUNHAVER LPC
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Gender | Female
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Dates
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Enumeration Date | 06/12/2023
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 1801 W WARNER AVE
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City | CHICAGO
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State | IL
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Zip | 60613-1891
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Country | US
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Telephone | 773-217-0540
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Fax |
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Provider Business Mailing Address
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Address Line | 1620 N WINCHESTER AVE BSMT
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City | CHICAGO
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State | IL
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Zip | 60622-0920
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Country | US
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Telephone | 618-795-9878
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC-08079T
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 178.018154
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License Number State | IL
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