Provider Demographics
NPI:1609604404
Name:ADAMS, KENISHA (MA,LPC)
Entity type:Individual
Prefix:MISS
First Name:KENISHA
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MA,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 W POLK ST STE 325
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-2175
Mailing Address - Country:US
Mailing Address - Phone:312-667-3884
Mailing Address - Fax:
Practice Address - Street 1:47 W POLK ST STE 325
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-2175
Practice Address - Country:US
Practice Address - Phone:312-667-3884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.020405101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional