Provider Demographics
NPI:1205376308
Name:BASSI, LISA J (LPC)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:J
Last Name:BASSI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 N FAIRFIELD ST
Mailing Address - Street 2:
Mailing Address - City:LIGONIER
Mailing Address - State:PA
Mailing Address - Zip Code:15658-1116
Mailing Address - Country:US
Mailing Address - Phone:724-238-7374
Mailing Address - Fax:
Practice Address - Street 1:233 E PITT ST
Practice Address - Street 2:SUITE/APT. 1
Practice Address - City:BEDFORD
Practice Address - State:PA
Practice Address - Zip Code:15522-1324
Practice Address - Country:US
Practice Address - Phone:814-623-7370
Practice Address - Fax:814-623-7375
Is Sole Proprietor?:No
Enumeration Date:2017-03-08
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC009036101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health