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Katie Marie Dominguez, LCPC,R-DMT,GL-CMA
Mental Health Counselor in Chicago, Illinois
NPI 1518427731

Katie Marie Dominguez is a Mental Health Counselor based in Chicago, IL and is specialized in Mental Health. Katie Marie Dominguez practices in Chicago, IL and has the professional credentials of LCPC,R-DMT,GL-CMA. The NPI Number for Katie Marie Dominguez is 1518427731 and holds a License No. (Illinois).

The current practice location address for Katie Marie Dominguez is 7639 N Greenview Ave Apt 3W, Chicago, IL and can be reached out via phone at 773-373-9682 and via fax at 773-312-4876.

Location: 7639 N Greenview Ave Apt 3W, Chicago, IL, 60626-1291
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Provider Profile Details
NPI Number
1518427731
Provider Name
Katie Marie Dominguez
Credential
LCPC,R-DMT,GL-CMA
Provider Entity Type
Individual
Gender
Female
Address
7639 N Greenview Ave Apt 3W, Chicago, IL, 60626-1291
Phone Number
773-373-9682
Fax Number
773-312-4876
Provider Enumeration Date
03/22/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1093474652 01 IL BCBS PPO INSURANCE OUTPATIENT PROVIDER
6839423 01 IL AETNA PPO OUTPATIENT PROVIDER
institution
Provider Business Practice Location Address Details
Address
7639 N Greenview Ave Apt 3W
City
State
Zip
60626-1291
Phone Number
773-373-9682
Fax Number
773-312-4876
person
Provider Business Mailing Address Details
Address
7639 N Greenview Ave Apt 3W
City
State
Zip
60626-1291
Phone Number
773-373-9682
Fax Number
773-312-4876
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
180.013363 (Illinois)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
()
Definition
Definition to come...
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