Provider Demographics
NPI:1477988830
Name:SUTTON, LISA M (LCAS)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:M
Last Name:SUTTON
Suffix:
Gender:F
Credentials:LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1101 ROANOKE AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536-3006
Mailing Address - Country:US
Mailing Address - Phone:252-767-6026
Mailing Address - Fax:252-572-4718
Practice Address - Street 1:1101 ROANOKE AVE
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-3006
Practice Address - Country:US
Practice Address - Phone:252-767-6026
Practice Address - Fax:252-572-4718
Is Sole Proprietor?:No
Enumeration Date:2013-09-04
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)