Provider Demographics
NPI:1275767295
Name:YOUNG, ALISA ZINSMEYER (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:ALISA
Middle Name:ZINSMEYER
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:MISS
Other - First Name:ALISA
Other - Middle Name:MARIE
Other - Last Name:ZINSMEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4242 MEDICAL DR STE 6250
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-5705
Mailing Address - Country:US
Mailing Address - Phone:210-614-3011
Mailing Address - Fax:210-615-6906
Practice Address - Street 1:4242 MEDICAL DR STE 6250
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-5705
Practice Address - Country:US
Practice Address - Phone:210-614-3011
Practice Address - Fax:210-615-6906
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-05
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63304101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional