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NPI Code Detail

MEDICARE: LISA JORGENSEN PROFESSIONAL CLINICAL COUNSELOR PROF CORP

MEDICARE: LISA JORGENSEN PROFESSIONAL CLINICAL COUNSELOR PROF CORP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor
2106H00000XMarriage & Family Therapist

General Provider Information

NPI Number : 1962354555
Entity Type Code : Organization
Provider Name (Legal Business Name) : LISA JORGENSEN PROFESSIONAL CLINICAL COUNSELOR PROF CORP
Provider Business Mailing Address
First Line : 24001 CALLE DE LA MAGDALENA UNIT 3253
Second Line :
City : LAGUNA HILLS
State : CA
Zip : 92654-1250
Country : US
Telephone Number : 657-210-2331
Fax Number :
Provider Business Practice Location Address
First Line : 27281 LAS RAMBLAS STE 208
Second Line :
City : MISSION VIEJO
State : CA
Zip : 92691-8303
Country : US
Telephone Number : 657-210-2331
Fax Number :
Authorized Official
Title or Position : OWNER/FOUNDER
Name : LISA JORGENSEN
Credential : MS, LMFT, LPCC
Telephone Number : 657-210-2331
Provider Enumeration Date : 02/13/2026
Last Update Date : 02/13/2026

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