Provider Demographics
NPI:1447677893
Name:STROMBERG, KEVIN (LCPC)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:STROMBERG
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 S BARRINGTON RD
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60193-5345
Mailing Address - Country:US
Mailing Address - Phone:815-469-1500
Mailing Address - Fax:217-284-9114
Practice Address - Street 1:321 S BARRINGTON RD
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60193-5345
Practice Address - Country:US
Practice Address - Phone:815-469-1500
Practice Address - Fax:217-284-9114
Is Sole Proprietor?:No
Enumeration Date:2014-03-24
Last Update Date:2024-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180008927101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional