Healthcare Provider Details

I. General information

NPI: 1609970706
Provider Name (Legal Business Name): LISA IRENE WILLIAMS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LISA IRENE GAY MA

II. Dates (important events)

Enumeration Date: 09/11/2006
Last Update Date: 10/11/2026
Certification Date: 10/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10350 E DAKOTA AVE STE B
DENVER CO
80247-1314
US

IV. Provider business mailing address

10350 E DAKOTA AVE
DENVER CO
80247-1314
US

V. Phone/Fax

Practice location:
  • Phone: 303-338-4545
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2006
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCCMH0153441
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: