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General NPI Number Information
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NPI Number | 1447439880
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Entity Type | Individual
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Provider Name | LISA A HAIN PSYD, NCSP, LPC
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Gender | Female
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Dates
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Enumeration Date | 11/02/2007
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 1600 SW ARCHER RD
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City | GAINESVILLE
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State | FL
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Zip | 32610-2912
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Country | US
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Telephone | 352-265-0301
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 100296
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City | GAINESVILLE
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State | FL
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Zip | 32610-0296
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Country | US
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Telephone | 352-627-9350
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Fax | 352-273-9054
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC004674
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PS016927
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License Number State | PA
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