Provider Demographics
NPI:1174869929
Name:LISA PISHA LLC
Entity type:Organization
Organization Name:LISA PISHA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LMFT
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:PISHA
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:630-815-3326
Mailing Address - Street 1:120 S WEBSTER ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-4479
Mailing Address - Country:US
Mailing Address - Phone:630-815-3326
Mailing Address - Fax:
Practice Address - Street 1:120 S WEBSTER ST
Practice Address - Street 2:SUITE 203
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-4479
Practice Address - Country:US
Practice Address - Phone:630-815-3326
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-26
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL166000781106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty