Provider Demographics
NPI:1386313229
Name:NIMROD, KATHERINE (LCPC)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:NIMROD
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 N COLUMBUS DR UNIT 7403
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-5264
Mailing Address - Country:US
Mailing Address - Phone:224-565-2627
Mailing Address - Fax:
Practice Address - Street 1:225 N COLUMBUS DR UNIT 7403
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-5264
Practice Address - Country:US
Practice Address - Phone:224-565-2627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-13
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.016046101YP2500X, 101Y00000X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor