Healthcare Provider Details

I. General information

NPI: 1922709690
Provider Name (Legal Business Name): LISA M BRIGHT LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2023
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3709 N LOCUST GROVE RD # 150
MERIDIAN ID
83646-5924
US

IV. Provider business mailing address

2498 N SHORTRIDGE PL
MERIDIAN ID
83646-9300
US

V. Phone/Fax

Practice location:
  • Phone: 208-718-2131
  • Fax: 888-850-9765
Mailing address:
  • Phone: 208-718-2131
  • Fax: 888-850-9765

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number8331389
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: