Healthcare Provider Details

I. General information

NPI: 1497114797
Provider Name (Legal Business Name): LISA MORRISON LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2016
Last Update Date: 11/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17606 COSHOCTON RD
MOUNT VERNON OH
43050-9218
US

IV. Provider business mailing address

17606 COSHOCTON RD
MOUNT VERNON OH
43050-9218
US

V. Phone/Fax

Practice location:
  • Phone: 740-397-0533
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.1091193
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1500168
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: