Healthcare Provider Details

I. General information

NPI: 1548723042
Provider Name (Legal Business Name): LISA HUNTER LPCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2019
Last Update Date: 04/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 KY 2227
SOMERSET KY
42503
US

IV. Provider business mailing address

300 HOPE ST
MT WASHINGTON KY
40047-7757
US

V. Phone/Fax

Practice location:
  • Phone: 606-677-1008
  • Fax:
Mailing address:
  • Phone: 502-538-1000
  • Fax: 502-538-1100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number244797
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: