Provider Demographics
NPI:1285037887
Name:FUECHTMANN, LISA LOIS (LCPC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:LOIS
Last Name:FUECHTMANN
Suffix:
Gender:
Credentials:LCPC
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:LOIS
Other - Last Name:CUEVAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:602 IVY CT
Mailing Address - Street 2:
Mailing Address - City:ROUND LAKE BEACH
Mailing Address - State:IL
Mailing Address - Zip Code:60073-2223
Mailing Address - Country:US
Mailing Address - Phone:773-656-3484
Mailing Address - Fax:
Practice Address - Street 1:4606 OLD GRAND AVE STE A2
Practice Address - Street 2:
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-2607
Practice Address - Country:US
Practice Address - Phone:773-656-3484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-27
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.009305101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional