Doctor Name: | MRS. KRISTIN MICHELLE KRIVICKAS |
NPI Number: | 1073814067 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW, CRADC |
License Number: | 30486 |
Business Practice Address: | 2215 14th St North Chicago, IL - 600641618 |
Business Phone Number: | 8479845231 |
Business Fax Number: | |
Mailing Address: | 343 Stevens Ct, GRAYSLAKE |
State: | IL |
Postal Code: | 600303532 |
Phone Number: | 8476914840 |
Fax Number: | |
NPI Enumeration Date: | 11/08/2010 |
NPI Last Update Date: | 06/03/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 30486 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |