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Individual
LISA M AMODEO
Active
Individual
LISA M AMODEO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC, CRADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
32734
IL
101YP2500X
Professional Counselor
Primary
180010582
IL
Other
Enumeration date
03/28/2017
Last updated
03/28/2017
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