Provider Demographics
NPI:1497829329
Name:MEHAFFEY, LISA SCHEMMEL (MA)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:SCHEMMEL
Last Name:MEHAFFEY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 HARRIS FARM RD
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28115-5768
Mailing Address - Country:US
Mailing Address - Phone:704-664-5351
Mailing Address - Fax:704-664-5351
Practice Address - Street 1:157 HARRIS FARM RD
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28115-5768
Practice Address - Country:US
Practice Address - Phone:704-664-5351
Practice Address - Fax:704-664-5351
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1040103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist