MEDICARE: LEENA ABUSHANAB LPC

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
1	101YM0800X	Mental Health Counselor	178.021022	IL

General Provider Information

NPI Number	:	1295543221
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEENA ABUSHANAB LPC

Provider Business Mailing Address
First Line	:	8701 W SURREY PARK
Second Line	:
City	:	PALOS HILLS
State	:	IL
Zip	:	60465-1193
Country	:	US
Telephone Number	:	708-821-5208
Fax Number	:

Provider Business Practice Location Address
First Line	:	8701 W SURREY PARK
Second Line	:
City	:	PALOS HILLS
State	:	IL
Zip	:	60465-1193
Country	:	US
Telephone Number	:	708-821-5208
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/23/2024
Last Update Date	:	12/23/2024

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Directions to “ LEENA ABUSHANAB LPC” Practice Location

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