Provider Demographics
NPI:1326110933
Name:ST. AUBYN, LISA JANE (LSCSW)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:JANE
Last Name:ST. AUBYN
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:MS
Other - First Name:LISA
Other - Middle Name:JANE
Other - Last Name:LILLARD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LSCSW
Mailing Address - Street 1:13626 W 95TH ST
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66215-3304
Mailing Address - Country:US
Mailing Address - Phone:913-317-8821
Mailing Address - Fax:913-541-8030
Practice Address - Street 1:13626 W 95TH ST
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-3304
Practice Address - Country:US
Practice Address - Phone:913-317-8821
Practice Address - Fax:913-541-8030
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS12431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS468229OtherBC & BS OF KS
KS31826014OtherBLUE CROSS & BLUE SHIELD
KS31826014OtherBLUE CROSS & BLUE SHIELD