Provider Demographics
NPI:1154311363
Name:CREE, LISA MICHELLE (LMHC, LCAC)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:MICHELLE
Last Name:CREE
Suffix:
Gender:F
Credentials:LMHC, LCAC
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:HOLLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2223 CANYON CREEK DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47909-8049
Mailing Address - Country:US
Mailing Address - Phone:765-404-3410
Mailing Address - Fax:
Practice Address - Street 1:100 SAW MILL RD STE 3200
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-5597
Practice Address - Country:US
Practice Address - Phone:765-404-1109
Practice Address - Fax:765-374-4164
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN87000116A101YA0400X
IN39000556A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000189086OtherANTHEM BCBS
IN000000189086OtherANTHEM BCBS