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Individual

JISELLE ROMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCPC

Contact information

Practice address
10720 PRINCESS AVE, CHICAGO RIDGE, IL 60415-2139
(773) 627-7914
(708) 575-6527
Mailing address
9631 S CICERO AVE # 1459, OAK LAWN, IL 60453-3137
(773) 627-7914
(708) 575-6527

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
178.007483
IL
101YP2500X
Professional Counselor
Primary
180.009936
IL
101YS0200X
School Counselor
2388551
IL

Other

Enumeration date
01/14/2014
Last updated
03/31/2023
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