Healthcare Provider Details

I. General information

NPI: 1073128096
Provider Name (Legal Business Name): LISETTE LI LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2020
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1490 S PRICE RD STE 108
CHANDLER AZ
85286-6606
US

IV. Provider business mailing address

1490 S PRICE RD STE 108
CHANDLER AZ
85286-6606
US

V. Phone/Fax

Practice location:
  • Phone: 480-931-4931
  • Fax: 602-926-8796
Mailing address:
  • Phone: 480-931-4931
  • Fax: 602-926-8796

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC-22652
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: