Provider Demographics
NPI:1508036740
Name:SCHENK, LISA KAREN (LPC, LCAS)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:KAREN
Last Name:SCHENK
Suffix:
Gender:F
Credentials:LPC, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 TIMBERLINE DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27101-6243
Mailing Address - Country:US
Mailing Address - Phone:336-723-6770
Mailing Address - Fax:
Practice Address - Street 1:801 TIMBERLINE DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101-6243
Practice Address - Country:US
Practice Address - Phone:336-723-6770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3712174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist