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General NPI Number Information
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NPI Number | 1851087175
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Entity Type | Individual
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Provider Name | KATHERINE ELIZABETH BOORAS NCC, LCPC, MA, BS
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Gender | Female
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Dates
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Enumeration Date | 04/12/2023
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Last Update Date | 11/01/2024
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Provider Practice Location Address
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Address Line | 872 S MILWAUKEE AVE # 182
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City | LIBERTYVILLE
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State | IL
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Zip | 60048-3227
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Country | US
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Telephone | 847-373-0941
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Fax |
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Provider Business Mailing Address
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Address Line | 872 S MILWAUKEE AVE # 182
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City | LIBERTYVILLE
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State | IL
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Zip | 60048-3227
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Country | US
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Telephone | 224-378-4240
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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 | 180.016456
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License Number State | IL
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