Healthcare Provider Details

I. General information

NPI: 1497819957
Provider Name (Legal Business Name): LISA A. LENARD L.P.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 02/22/2021
Certification Date: 02/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 S 3RD AVE
ALPENA MI
49707-4105
US

IV. Provider business mailing address

1035 W WASHINGTON AVE
ALPENA MI
49707-2929
US

V. Phone/Fax

Practice location:
  • Phone: 989-356-4049
  • Fax:
Mailing address:
  • Phone: 989-358-0673
  • Fax: 989-736-8278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401008904
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: