Provider Demographics
NPI:1033977251
Name:TRELEAVEN, LISA (EDD, LPC)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:
Last Name:TRELEAVEN
Suffix:
Gender:F
Credentials:EDD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16915 WALDEN RD # 311
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77356-3219
Mailing Address - Country:US
Mailing Address - Phone:832-422-6036
Mailing Address - Fax:
Practice Address - Street 1:16915 WALDEN RD # 311
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:TX
Practice Address - Zip Code:77356-3219
Practice Address - Country:US
Practice Address - Phone:832-422-6036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-12
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66262101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional