Healthcare Provider Details

I. General information

NPI: 1144772781
Provider Name (Legal Business Name): LISA SCOTT-SPOERKE LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2016
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 CHAPEL PLACE UNIT 208
AVON CO
81620
US

IV. Provider business mailing address

2925 CHICAGO AVE
MINNEAPOLIS MN
55407-1321
US

V. Phone/Fax

Practice location:
  • Phone: 231-622-3226
  • Fax:
Mailing address:
  • Phone: 866-603-0016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLPCC.0015016
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3848
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: