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NPI Code Detail

MEDICARE: MS. LISA A. WHITTINGHAM BRENNAN M.ED, LCPC

MEDICARE: MS. LISA A. WHITTINGHAM BRENNAN M.ED, LCPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2101YP2500XProfessional Counselor180002937IL

General Provider Information

NPI Number : 1053566422
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LISA A. WHITTINGHAM BRENNAN M.ED, LCPC
Provider Business Mailing Address
First Line : 17 N WABASH AVE STE 515
Second Line :
City : CHICAGO
State : IL
Zip : 60602-4818
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 17 N WABASH AVE STE 515
Second Line :
City : CHICAGO
State : IL
Zip : 60602-4818
Country : US
Telephone Number : 708-557-1980
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/26/2008
Last Update Date : 09/23/2022

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