Provider Demographics
NPI:1831986926
Name:LISSEN THERAPY, LLC
Entity type:Organization
Organization Name:LISSEN THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SHAKENDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUCAS
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:904-413-8726
Mailing Address - Street 1:6501 ARLINGTON EXPRESSWAY B105
Mailing Address - Street 2:#2155
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32211-0810
Mailing Address - Country:US
Mailing Address - Phone:870-995-0932
Mailing Address - Fax:904-506-7807
Practice Address - Street 1:7740 PLANTATION BAY DR APT 109
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32244-5185
Practice Address - Country:US
Practice Address - Phone:904-413-8726
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty