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General NPI Number Information
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NPI Number | 1124832167
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Entity Type | Individual
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Provider Name | MS. KAVYA KORLAPATI
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Gender | Female
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Dates
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Enumeration Date | 02/01/2025
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Last Update Date | 02/01/2025
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Provider Practice Location Address
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Address Line | 2259 S DAMEN AVE
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City | CHICAGO
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State | IL
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Zip | 60608-4232
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Country | US
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Telephone | 872-281-7575
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Fax |
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Provider Business Mailing Address
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Address Line | 1504 N DEARBORN PKWY APT 412
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City | CHICAGO
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State | IL
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Zip | 60610-1427
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Country | US
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Telephone | 773-290-7606
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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 | 178021226
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License Number State | IL
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