Healthcare Provider Details

I. General information

NPI: 1366807505
Provider Name (Legal Business Name): LISA HARWELL LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2015
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19980 ARMY AVIATION DR
RENO NV
89506-1299
US

IV. Provider business mailing address

19980 ARMY AVIATION DR
RENO NV
89506-1299
US

V. Phone/Fax

Practice location:
  • Phone: 775-300-3176
  • Fax:
Mailing address:
  • Phone: 775-300-3176
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC001243
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCP5617-R
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: