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General NPI Number Information
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NPI Number | 1003556416
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Entity Type | Individual
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Provider Name | LYNSEY LATTYAK LCPC
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Gender | Female
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Dates
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Enumeration Date | 04/01/2022
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Last Update Date | 11/14/2025
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Provider Practice Location Address
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Address Line | 3329 75TH ST. 2ND FL.
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City | WOODRIDGE
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State | IL
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Zip | 60517-2700
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Country | US
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Telephone | 630-964-9400
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Fax | 630-964-9375
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Provider Business Mailing Address
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Address Line | 13955 W GRENELEFE LN
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City | HOMER GLEN
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State | IL
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Zip | 60491-5923
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 178016352
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 178016352
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180016985
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License Number State | IL
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