Healthcare Provider Details

I. General information

NPI: 1083558027
Provider Name (Legal Business Name): LISA ANN TOWER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 05/02/2026
Certification Date: 05/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1516 E JULEP CIR
MESA AZ
85203-2710
US

IV. Provider business mailing address

1516 E JULEP CIR
MESA AZ
85203-2710
US

V. Phone/Fax

Practice location:
  • Phone: 480-329-3699
  • Fax:
Mailing address:
  • Phone: 480-329-3699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-24718
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: