Lisa Wallace
Lisa Wallace provides Counselor services in Olympia Fields, Illinois. Licensed in Illinois. Registered with an NPI since 2014.
- Licensed in
- IL
- In the registry since
- 2014
- Specialties on file
- 6
Practice location Address checks out
20200 Governors Dr 107Olympia Fields, IL 60461-1032 Not confirmed with CMS for 12 years — call before visiting
Phone: (708) 462-4235
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Mental Health Counselor (primary) | Taxonomy 101YM0800X · Licence 180.008731 (IL) |
|---|---|
| Counselor | Taxonomy 101Y00000X · Licence 180.008731 (IL) |
| Addiction (Substance Use Disorder) Counselor | Taxonomy 101YA0400X · Licence 180.008731 (IL) |
| Pastoral Counselor | Taxonomy 101YP1600X · Licence 180.008731 (IL) |
| Professional Counselor | Taxonomy 101YP2500X · Licence 180.008731 (IL) |
| Marriage & Family Therapist | Taxonomy 106H00000X · Licence 180.008731 (IL) |
Record details
| NPI number | 1427463405 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Lisa Wallace — Provider · (708) 906-0205 |
| NPI enumerated | June 27, 2014 |
| Last updated in NPPES | June 27, 2014 |
| Mailing address | 1835 W 34th St, Steger, IL 60475-1499 |
Other providers in Olympia Fields
-
True Space Counseling and Psychological Services
20280 Governors Hwy Ste 105, Olympia Fields, IL 60461-1068 · (312) 248-3481