Provider Demographics
NPI:1326922097
Name:DEVARAKONDA, KIRTHANA (MA, LPC, NCC, QMHP)
Entity type:Individual
Prefix:
First Name:KIRTHANA
Middle Name:
Last Name:DEVARAKONDA
Suffix:
Gender:F
Credentials:MA, LPC, NCC, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 W BELMONT AVE STE 400F407E
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-3200
Mailing Address - Country:US
Mailing Address - Phone:708-391-5619
Mailing Address - Fax:
Practice Address - Street 1:3450 ROXBORO RD NE APT 5310
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30326-1792
Practice Address - Country:US
Practice Address - Phone:872-325-9913
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178021915101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health