Kyle Lee Lisowski, LCPC
Counselor, Professional in New Lenox, IL. Individual provider (NPI-1).
NPI number1982114922
StatusActive
Last updated in NPPESOct 4, 2023
Details
- NPI
- 1982114922
- Entity type
- Individual (NPI-1)
- Name
- Kyle Lee Lisowski
- Credential
- LCPC
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Oct 4, 2017
- Certification date
- Oct 4, 2023
- Last updated
- Oct 4, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 180.012016 | IL | Yes |
| 101YP2500X | Counselor, Professional | 178.012900 | IL |
Practice location
1938 E Lincoln HwyNew Lenox, IL 60451-3810
Phone 708-828-4636
Mailing address
11004 1st StMokena, IL 60448-1506
Other practice locations
13136 Western Ave
Blue Island, IL 60406-2423
Blue Island, IL 60406-2423
Phone 708-828-4636
11004 1st St
Mokena, IL 60448-1506
Mokena, IL 60448-1506
Phone 708-828-4636
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