Provider Demographics
NPI:1326409764
Name:MENGEU, LISA M
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:MENGEU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:SCHULLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:1 ROSS PARK BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-2681
Mailing Address - Country:US
Mailing Address - Phone:740-264-7751
Mailing Address - Fax:740-264-2422
Practice Address - Street 1:1 ROSS PARK BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-2681
Practice Address - Country:US
Practice Address - Phone:740-264-7751
Practice Address - Fax:740-264-2422
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-13
Last Update Date:2016-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1600066101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional