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General NPI Number Information
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NPI Number | 1437216561
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Entity Type | Organization
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Legal Business Name | LISALISTENS, INC
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Dates
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Enumeration Date | 01/01/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6600 W COLLEGE DR STE. 210
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City | PALOS HEIGHTS
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State | IL
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Zip | 60463-1775
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Country | US
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Telephone | 773-487-3405
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Fax | 773-628-7773
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Provider Business Mailing Address
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Address Line | 430 E 162ND ST UNIT 153
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City | SOUTH HOLLAND
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State | IL
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Zip | 60473-2258
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Country | US
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Telephone | 773-487-3405
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Fax | 773-628-7773
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Authorized Official
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Title or Position | COUNSELOR
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Name | MS. LISA LOURY-LOMAS
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Credential | LCPC
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Telephone | 773-487-3405
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State | IL
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