Provider Demographics
NPI:1053632190
Name:ROBINSON, LISA M (LLPC)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:M
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:MS
Other - First Name:LISA
Other - Middle Name:M
Other - Last Name:PERRY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4170 FARNER AVE
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48329-4104
Mailing Address - Country:US
Mailing Address - Phone:248-762-4286
Mailing Address - Fax:
Practice Address - Street 1:6637 HIGHLAND RD
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48327-1675
Practice Address - Country:US
Practice Address - Phone:248-666-8870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-11
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401011777101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor