Provider Demographics
NPI:1720883259
Name:ROMAN, LIZETTE (LPC, NCC, CADC)
Entity type:Individual
Prefix:
First Name:LIZETTE
Middle Name:
Last Name:ROMAN
Suffix:
Gender:
Credentials:LPC, NCC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13013 S CARONDOLET AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60633-1701
Mailing Address - Country:US
Mailing Address - Phone:773-425-2558
Mailing Address - Fax:
Practice Address - Street 1:13013 S CARONDOLET AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60633-1701
Practice Address - Country:US
Practice Address - Phone:773-425-2558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.014764101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional