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General NPI Number Information
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NPI Number | 1871895631
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Entity Type | Individual
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Provider Name | KATHRYN OLDENBURG LCPC
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Gender | Female
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Dates
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Enumeration Date | 11/30/2010
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Last Update Date | 03/12/2013
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Provider Practice Location Address
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Address Line | 675 N NORTH CT SUITE 285
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City | PALATINE
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State | IL
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Zip | 60067-8157
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Country | US
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Telephone | 847-221-5622
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Fax | 847-221-5688
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Provider Business Mailing Address
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Address Line | 675 N NORTH CT SUITE 285
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City | PALATINE
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State | IL
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Zip | 60067-8157
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Country | US
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Telephone | 847-221-5622
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Fax | 847-221-5688
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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 | 180.007639
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License Number State | IL
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