Provider Demographics
NPI:1326697814
Name:PSYCHOTHERAPY SERVICES BY LISA STEIN, LMFT
Entity Type:Organization
Organization Name:PSYCHOTHERAPY SERVICES BY LISA STEIN, LMFT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:SHARON
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:707-766-8567
Mailing Address - Street 1:7 4TH ST STE 7
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94952-3072
Mailing Address - Country:US
Mailing Address - Phone:707-766-8567
Mailing Address - Fax:
Practice Address - Street 1:7 4TH ST STE 7
Practice Address - Street 2:
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94952-3072
Practice Address - Country:US
Practice Address - Phone:707-766-8567
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-06
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health