Provider Demographics
NPI:1497463129
Name:ADLER, LISA KAY (LPC-MH)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:KAY
Last Name:ADLER
Suffix:
Gender:F
Credentials:LPC-MH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 N WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:SD
Mailing Address - Zip Code:57445-2226
Mailing Address - Country:US
Mailing Address - Phone:605-228-3134
Mailing Address - Fax:
Practice Address - Street 1:403 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:SD
Practice Address - Zip Code:57445-2226
Practice Address - Country:US
Practice Address - Phone:605-228-3134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-11
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC-MH2060101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health