Provider Demographics
NPI:1114576840
Name:SLEEZER, LISA LYNN (MA-LCPC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:LYNN
Last Name:SLEEZER
Suffix:
Gender:F
Credentials:MA-LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1282 CLEARWATER DR
Mailing Address - Street 2:
Mailing Address - City:YORKVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60560-2400
Mailing Address - Country:US
Mailing Address - Phone:630-553-2283
Mailing Address - Fax:
Practice Address - Street 1:1282 CLEARWATER DR
Practice Address - Street 2:
Practice Address - City:YORKVILLE
Practice Address - State:IL
Practice Address - Zip Code:60560-2400
Practice Address - Country:US
Practice Address - Phone:630-553-2283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-05
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180011966101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health