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General NPI Number Information
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NPI Number | 1831986926
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Entity Type | Organization
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Legal Business Name | LISSEN THERAPY, LLC
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Dates
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Enumeration Date | 04/22/2025
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 7740 PLANTATION BAY DR APT 109
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City | JACKSONVILLE
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State | FL
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Zip | 32244-5185
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Country | US
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Telephone | 904-413-8726
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Fax |
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Provider Business Mailing Address
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Address Line | 6501 ARLINGTON EXPRESSWAY B105 #2155
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City | JACKSONVILLE
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State | FL
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Zip | 32211-0810
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Country | US
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Telephone | 870-995-0932
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Fax | 904-506-7807
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | SHAKENDRA LUCAS
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Credential | LMHC
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Telephone | 904-413-8726
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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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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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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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