Provider Demographics
NPI:1275910945
Name:TERRAZAS, LISA (LPC)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:
Last Name:TERRAZAS
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 1:400A W DITTMAR RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-6513
Mailing Address - Country:US
Mailing Address - Phone:210-363-4444
Mailing Address - Fax:
Practice Address - Street 1:3625 MANCHACA RD STE 303
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-5912
Practice Address - Country:US
Practice Address - Phone:210-363-4444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-01
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68311101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional