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General NPI Number Information
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NPI Number | 1629356936
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Entity Type | Individual
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Provider Name | LISA MARIE LOAR LPC-MHSP
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Gender | Female
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Dates
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Enumeration Date | 08/03/2011
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Last Update Date | 08/03/2011
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Provider Practice Location Address
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Address Line | 7900 JOHNSON DRIVE BOX 98
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City | KNOXVILLE
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State | TN
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Zip | 37998
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Country | US
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Telephone | 865-251-2836
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Fax | 865-251-2435
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Provider Business Mailing Address
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Address Line | 2306 MOUNT OLIVE ROAD
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City | KNOXVILLE
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State | TN
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Zip | 37920
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Country | US
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Telephone | 865-405-7286
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 2720
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License Number State | TN
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