Provider Demographics
NPI:1548004898
Name:KATHARINE HOUPT THERAPY PLLC
Entity type:Organization
Organization Name:KATHARINE HOUPT THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHARINE
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:HOUPT
Authorized Official - Suffix:
Authorized Official - Credentials:ATR-BC, LCPC
Authorized Official - Phone:872-216-0658
Mailing Address - Street 1:53 W JACKSON BLVD STE 564
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60604-3683
Mailing Address - Country:US
Mailing Address - Phone:872-216-0658
Mailing Address - Fax:
Practice Address - Street 1:53 W JACKSON BLVD STE 564
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60604-3683
Practice Address - Country:US
Practice Address - Phone:872-216-0658
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-21
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1962858092OtherBCBS ILLINOIS, CIGNA