Provider Demographics
NPI:1467577858
Name:WHITSITT, LISA (MA, LMHC, CP)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:WHITSITT
Suffix:
Gender:F
Credentials:MA, LMHC, CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:906 N 78TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-4710
Mailing Address - Country:US
Mailing Address - Phone:206-226-0999
Mailing Address - Fax:
Practice Address - Street 1:2207 NE 65TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-7097
Practice Address - Country:US
Practice Address - Phone:206-226-0999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00010801101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health