Provider Demographics
NPI:1467643817
Name:KATTNER, LISA MICHELLE (MSW, LMHC)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:MICHELLE
Last Name:KATTNER
Suffix:
Gender:F
Credentials:MSW, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9010 W SMITH ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:YORKTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:47396-1313
Mailing Address - Country:US
Mailing Address - Phone:765-405-0550
Mailing Address - Fax:765-381-1000
Practice Address - Street 1:9010 W SMITH ST
Practice Address - Street 2:SUITE 2
Practice Address - City:YORKTOWN
Practice Address - State:IN
Practice Address - Zip Code:47396-1313
Practice Address - Country:US
Practice Address - Phone:765-405-0550
Practice Address - Fax:765-381-1000
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-08
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39001842A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health