Provider Demographics
NPI:1851918908
Name:LIESER COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:LIESER COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:LIESER
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:773-706-8277
Mailing Address - Street 1:4848 N SHERIDAN RD APT 308
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-6976
Mailing Address - Country:US
Mailing Address - Phone:773-706-8277
Mailing Address - Fax:773-326-3797
Practice Address - Street 1:1122 W CATALPA AVE STE 1W
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-7023
Practice Address - Country:US
Practice Address - Phone:773-706-8277
Practice Address - Fax:773-326-3797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-05
Last Update Date:2020-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty