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General NPI Number Information
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NPI Number | 1467293597
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Entity Type | Organization
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Legal Business Name | LPL COUNSELING
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Dates
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Enumeration Date | 06/03/2024
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Last Update Date | 06/18/2024
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Provider Practice Location Address
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Address Line | 1131 CENTRAL AVE STE 14
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City | WILMETTE
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State | IL
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Zip | 60091-2645
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Country | US
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Telephone | 773-484-8343
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Fax |
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Provider Business Mailing Address
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Address Line | 209 15TH ST
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City | WILMETTE
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State | IL
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Zip | 60091-3232
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Country | US
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Telephone | 773-484-8343
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | LISA LEVENS
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Credential | MA, LCPC
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Telephone | 773-484-8343
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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 |
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