Provider Demographics
NPI:1336321546
Name:DELCORE, LISA JEAN (LMFT, AAMFT AS)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:JEAN
Last Name:DELCORE
Suffix:
Gender:F
Credentials:LMFT, AAMFT AS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 3RD ST S
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-1714
Mailing Address - Country:US
Mailing Address - Phone:808-589-8992
Mailing Address - Fax:
Practice Address - Street 1:3200 3RD ST S
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-1714
Practice Address - Country:US
Practice Address - Phone:808-589-8992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-29
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT2405106H00000X
HIMFT-348106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist