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General NPI Number Information
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NPI Number | 1457287815
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Entity Type | Organization
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Legal Business Name | AMANI THERAPY PRACTICE LLC
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Dates
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Enumeration Date | 06/22/2026
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Last Update Date | 06/22/2026
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Provider Practice Location Address
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Address Line | 485 GORDON AVE
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City | CALUMET CITY
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State | IL
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Zip | 60409-3527
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Country | US
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Telephone | 708-437-6786
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Fax |
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Provider Business Mailing Address
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Address Line | 1 E ERIE ST
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City | CHICAGO
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State | IL
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Zip | 60611-2740
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Country | US
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Telephone | 708-437-6786
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | AUDREY LESTER
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Credential | LCSW
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Telephone | 708-437-6786
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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 |
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License Number State |
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