Healthcare Provider Details

I. General information

NPI: 1255753539
Provider Name (Legal Business Name): LISA MARIE LAHR MA, IADC, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LISA MARIE BISCHOFF MA, IADC, LMHC

II. Dates (important events)

Enumeration Date: 01/06/2014
Last Update Date: 09/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1340 BLAIRS FERRY RD STE 1
HIAWATHA IA
52233-1900
US

IV. Provider business mailing address

1340 BLAIRS FERRY RD STE 1
HIAWATHA IA
52233-1900
US

V. Phone/Fax

Practice location:
  • Phone: 319-398-6641
  • Fax: 319-369-4673
Mailing address:
  • Phone: 319-398-6641
  • Fax: 319-369-4673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number15067
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number001582
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number20768
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: