Provider Demographics
NPI:1275100042
Name:MCCURRY, LISA MAY (LMFT)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:MAY
Last Name:MCCURRY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22602 COSTA BELLA DR
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-4218
Mailing Address - Country:US
Mailing Address - Phone:888-846-8569
Mailing Address - Fax:
Practice Address - Street 1:22602 COSTA BELLA DR
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-4218
Practice Address - Country:US
Practice Address - Phone:888-846-8569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-09
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA122272106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist