NPI 1003051574

Kevin James Brannick, LPC

Practitioner Professional Counselor Riverside, IL

Practice location

Address: 3200 Harlem Ave, Riverside, IL 60546-2012
Phone: (708) 447-2468
Fax: (708) 447-0043

Registered specialties

Professional Counselor Primary

Behavioral Health & Social Service Providers Taxonomy 101YP2500X Licence 178002986 (IL)

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Registry record

NPI: 1003051574
Entity type: Individual
Sex (as registered): Male
NPI issued: 11 Dec 2008
Record last updated: 11 Dec 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.