Healthcare Provider Details

I. General information

NPI: 1750144572
Provider Name (Legal Business Name): LISA RENEE MATHEWS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LISA RENEE JONES

II. Dates (important events)

Enumeration Date: 02/05/2024
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 WILCREST DR STE 434
HOUSTON TX
77042-3399
US

IV. Provider business mailing address

4906 ARVIDA LN
FRESNO TX
77545-2224
US

V. Phone/Fax

Practice location:
  • Phone: 832-653-1522
  • Fax:
Mailing address:
  • Phone: 832-653-1522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number205235
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number88845
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: