Healthcare Provider Details

I. General information

NPI: 1487996047
Provider Name (Legal Business Name): LISA ANNE DILLE LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LISA ANNE BATEY LPCC

II. Dates (important events)

Enumeration Date: 03/21/2013
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1705 INDIAN WOOD CIR STE 200
MAUMEE OH
43537-4046
US

IV. Provider business mailing address

1705 INDIAN WOOD CIR STE 200
MAUMEE OH
43537-4046
US

V. Phone/Fax

Practice location:
  • Phone: 419-969-7243
  • Fax:
Mailing address:
  • Phone: 419-969-7243
  • Fax: 419-740-1977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number121014
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.0800032
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: