Provider Demographics
NPI:1649679838
Name:WIX, KATHERINE MARIE (LPC)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MARIE
Last Name:WIX
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:MARIE
Other - Last Name:ATKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:25 E SCHAUMBURG RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60194-3550
Mailing Address - Country:US
Mailing Address - Phone:847-981-3514
Mailing Address - Fax:847-230-3787
Practice Address - Street 1:25 E SCHAUMBURG RD
Practice Address - Street 2:SUITE 106
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60194-3550
Practice Address - Country:US
Practice Address - Phone:847-981-3514
Practice Address - Fax:847-230-3787
Is Sole Proprietor?:No
Enumeration Date:2014-08-14
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.009161101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor