Gleaves, Kenneth A

Gleaves, Kenneth A is an sole proprietor health care provider with primary practice located at 3450 W Maple St Rm 200 , Evergreen Park IL 60805-3043. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Gleaves, Kenneth A can be contacted via phone (708) 422-2885.

Contact Information

Primary practice address
3450 W Maple St Rm 200 Evergreen Park IL 60805-3043
Phone: (708) 422-2885
Fax: (708) 422-7161
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 2812 Illinois
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 006460 Virginia
Behavioral Health & Social Service Providers / Professional 101YP2500X 180001207 Illinois

Profile Details

NPI number 1609984764
LBN Legal business name Gleaves, Kenneth A
Credentials PH.D., LCPC, NCACI
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 29th, 2006
Last updated Feb 16th, 2024 - about 9 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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