Organization
MIDWEST PUBLIC SAFETY PSYCHOLOGICAL SERVICES, LTD
Active
Other names
Midwest Public Safety Psychological Services, LTD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GENESSA LEWIS PSYD, RXP (OWNER)
(708) 942-7474
Entity
Organization
Contact information
Practice address
6601 NORTH AVE, OAK PARK, IL 60302-1084
(708) 942-7474
Mailing address
1706 N NEWCASTLE AVE, CHICAGO, IL 60707-4422
(773) 972-0288
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
103TP0016X
Prescribing (Medical) Psychologist
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
11/08/2024
Last updated
12/02/2024
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