Provider Demographics
NPI:1437979838
Name:KRISTEN POWELL THERAPY AND CONSULTING, LLC
Entity type:Organization
Organization Name:KRISTEN POWELL THERAPY AND CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:630-956-6041
Mailing Address - Street 1:20 DANADA SQ W # 219
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60189-2000
Mailing Address - Country:US
Mailing Address - Phone:630-956-6041
Mailing Address - Fax:
Practice Address - Street 1:800 ROOSEVELT RD STE 220
Practice Address - Street 2:
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-5839
Practice Address - Country:US
Practice Address - Phone:630-956-6041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-11
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health