Individual provider · Type 1 NPI
Malissa/lisa Lynn Dieterle, LCPC; CADC
Professional Counselor · Chicago, IL
NPI number
1669276242
Active
Practice location
1005 N Western Ave Unit 3
Chicago, IL 60622-6224
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 18283 (IL) |
| Professional Counselor Primary | 101YP2500X | 180-003908 (IL) |
Professional Counselor: Definition to come...
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About NPI 1669276242
Malissa/lisa Lynn Dieterle, LCPC; CADC's National Provider Identifier is 1669276242, issued on Apr 2, 2025. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Chicago, IL. The record was last updated on Apr 2, 2025.