Provider Demographics
NPI:1407737273
Name:YARNELL, KRISTIN (LPC, CADC, CODP II)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:YARNELL
Suffix:
Gender:F
Credentials:LPC, CADC, CODP II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 N MULFORD RD
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61107-3874
Mailing Address - Country:US
Mailing Address - Phone:888-928-0212
Mailing Address - Fax:
Practice Address - Street 1:28371 DAVIS PKWY STE 102
Practice Address - Street 2:
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555-3035
Practice Address - Country:US
Practice Address - Phone:630-520-9205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36042101YA0400X
IL178.015052101YM0800X
IL34884101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health