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General NPI Number Information
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NPI Number | 1942171426
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Entity Type | Organization
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Legal Business Name | TRUST & TRANSFORM COUNSELING, PLLC
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Dates
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Enumeration Date | 09/16/2025
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 532 LAKE ST
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City | ANTIOCH
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State | IL
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Zip | 60002-1424
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Country | US
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Telephone | 224-652-9085
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Fax |
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Provider Business Mailing Address
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Address Line | 532 LAKE ST
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City | ANTIOCH
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State | IL
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Zip | 60002-1424
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Country | US
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Telephone | 224-652-9085
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | KRISTAN A CAMERON
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Credential | LCPC
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Telephone | 224-652-9085
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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