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General NPI Number Information
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NPI Number | 1720962079
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Entity Type | Organization
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Legal Business Name | LONDON WELLNESS FOUNDATION
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Dates
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Enumeration Date | 07/31/2025
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 405 W SUPERIOR ST FL 7
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City | CHICAGO
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State | IL
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Zip | 60654-8559
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Country | US
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Telephone | 312-848-1534
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Fax |
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Provider Business Mailing Address
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Address Line | 40 E HURON ST STE 300
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City | CHICAGO
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State | IL
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Zip | 60611-5244
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Country | US
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Telephone | 312-656-2638
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. LISA LONDON
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Credential | LCPC, NCC, DBH
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Telephone | 312-848-1534
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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