Provider Demographics
NPI:1295543221
Name:ABUSHANAB, LEENA (LPC)
Entity type:Individual
Prefix:
First Name:LEENA
Middle Name:
Last Name:ABUSHANAB
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8701 W SURREY PARK
Mailing Address - Street 2:
Mailing Address - City:PALOS HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60465-1193
Mailing Address - Country:US
Mailing Address - Phone:708-821-5208
Mailing Address - Fax:
Practice Address - Street 1:8701 W SURREY PARK
Practice Address - Street 2:
Practice Address - City:PALOS HILLS
Practice Address - State:IL
Practice Address - Zip Code:60465-1193
Practice Address - Country:US
Practice Address - Phone:708-821-5208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-23
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.021022101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health