Organization
LEAP THERAPY CHICAGO, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA E PETERSON LMFT (MANAGER / OWNER)
(312) 278-3771
Entity
Organization
Contact information
Practice address
1770 W BERTEAU AVE STE 304, CHICAGO, IL 60613-6131
(312) 278-3771
Mailing address
1770 W BERTEAU AVE STE 304, CHICAGO, IL 60613-6131
(312) 278-3771
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
106H00000X
Marriage & Family Therapist
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/02/2023
Last updated
10/04/2024
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