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NPI 1063871101

NPI 1063871101 : KIRSTY DUFFETT : ELGIN, IL

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General NPI Number Information
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    NPI Number           |    1063871101
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    Entity Type          |    Individual 
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    Provider Name        |    KIRSTY DUFFETT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/17/2016
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    Last Update Date     |    09/23/2025
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Provider Practice Location Address
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    Address Line         |    675 VARSITY DRIVE 
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    City                 |    ELGIN
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    State                |    IL
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    Zip                  |    60120
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    Country              |    US
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    Telephone            |    847-741-2600
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    675 VARSITY DRIVE 
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    City                 |    ELGIN
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    State                |    IL
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    Zip                  |    60120
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    Country              |    US
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    Telephone            |    847-741-2600
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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       |    180016305
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    License Number State |    IL
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Taxonomy #2
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    Taxonomy Code        |    101YA0400X
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    Taxonomy Name        |    Addiction (Substance Use Disorder) Counselor
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    License Number       |    32187
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    License Number State |    IL
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