Walter Lisatowicz, BSW

Individual provider Active NPI Mental Health Counselor · Wheaton, IL

NPI 1851665517 · NPPES record last updated Feb 28, 2012

Key facts

NPI
1851665517
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
422 N Prospect St
Wheaton, IL 60187-5839
Phone
(630) 682-7400
NPI assigned
Feb 28, 2012
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

422 N Prospect St
Wheaton, IL 60187-5839

Mailing address

111 N County Farm Rd
Wheaton, IL 60187-3977

Other providers in Wheaton, IL

All providers in Wheaton, IL · Mental Health Counselor in Illinois

Sources for this page

Verify at the official NPI Registry.