Provider Demographics
NPI:1225356587
Name:DUNGATE, LISA CATHERINE (PSYD, MA, LMHC)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:CATHERINE
Last Name:DUNGATE
Suffix:
Gender:F
Credentials:PSYD, MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 HENRY ST
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-3232
Mailing Address - Country:US
Mailing Address - Phone:518-581-3180
Mailing Address - Fax:518-581-3182
Practice Address - Street 1:58 HENRY ST
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-3232
Practice Address - Country:US
Practice Address - Phone:518-581-3180
Practice Address - Fax:581-581-3182
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-12
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005231-1101YM0800X
CA25683103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103T00000XBehavioral Health & Social Service ProvidersPsychologist