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JISELLE ROMAN LCPC PLLC NPI 1649917345


NPI Information

NPI: 1649917345
Provider Name: JISELLE ROMAN LCPC PLLC
Classification: Counselor - 101YP2500X
Entity Type: Organization

Specialization: Professional

Address:
10720 PRINCESS AVE
CHICAGO RIDGE, IL
ZIP 60415
Phone: (773) 627-7914
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JISELLE ROMAN LCPC PLLC is a professional counselor in Chicago Ridge, IL. JISELLE ROMAN LCPC PLLC NPI is 1649917345. The provider is registered as an organization entity type.

The provider's business location address is:

10720 PRINCESS AVE
CHICAGO RIDGE, IL
ZIP 60415-139
Phone: (773) 627-7914
Fax: (708) 575-6527

The provider's authorized official is Jiselle Roman .
The authorized official title is Licensed Clinical Professional Coun and has the following contact phone number (773) 627-7914.

The enumeration date for this NPI number is 5/16/2022 and was last updated on 11/4/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251S00000XCommunity/Behavioral HealthNo
2261QM0850XClinic/CenterAdult Mental HealthNo
3261QM0855XClinic/CenterAdolescent and Children Mental HealthNo
4101YP2500XCounselorProfessionalYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11750703583OTHERILLINOISNPI 1

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024
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