| Organization Name: | LISA MEDANIC COUNSELING, LTD. |
| NPI Number: | 1275716136 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LISA C. MEDANIC (PRESIDENT) |
| Mailing Address: | 29w120 Butterfield Rd Ste 104a Warrenville |
| State: | IL US |
| Postal Code: | 605552830 |
| Phone Number: | 6303934019 |
| Fax Number: | 6309049871 |
| NPI Enumeration Date: | 12/13/2007 |
| NPI Last Update Date: | 12/13/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |