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General NPI Number Information
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NPI Number | 1154365831
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Entity Type | Individual
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Provider Name | SHABAD KAUR KHALSA LCPC, LMFT
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Gender | Female
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 848 DODGE AVE # 256
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City | EVANSTON
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State | IL
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Zip | 60202-1506
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Country | US
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Telephone | 773-480-3273
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Fax | 773-326-2444
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Provider Business Mailing Address
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Address Line | 4255 N HONORE ST STE 219
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City | CHICAGO
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State | IL
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Zip | 60613-4572
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Country | US
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Telephone | 773-975-9754
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 166000327
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License Number State | IL
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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 | 180005774
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License Number State | IL
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