Provider Demographics
NPI:1841495017
Name:WITT, LEILANI J (LPC)
Entity type:Individual
Prefix:MS
First Name:LEILANI
Middle Name:J
Last Name:WITT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5412 N GLENWOOD AVE
Mailing Address - Street 2:#2
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-1204
Mailing Address - Country:US
Mailing Address - Phone:773-561-7422
Mailing Address - Fax:
Practice Address - Street 1:130 WAUKEGAN RD
Practice Address - Street 2:SUITE 102
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-5652
Practice Address - Country:US
Practice Address - Phone:847-940-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health