Provider Demographics
NPI:1164999249
Name:HARLEY, LISA (LPC)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:HARLEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:CANZATER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:2021 21ST AVENUE
Mailing Address - Street 2:STE C400
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212-4350
Mailing Address - Country:US
Mailing Address - Phone:615-293-7462
Mailing Address - Fax:615-369-3059
Practice Address - Street 1:2021 21ST AVENUE
Practice Address - Street 2:STE C400
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-4350
Practice Address - Country:US
Practice Address - Phone:615-293-7462
Practice Address - Fax:615-369-3059
Is Sole Proprietor?:No
Enumeration Date:2018-10-26
Last Update Date:2022-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
SC6976101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional