Provider Demographics
NPI:1518082759
Name:HEMSTREET, LISA RENEE (MS,HSP-PA)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:RENEE
Last Name:HEMSTREET
Suffix:
Gender:F
Credentials:MS,HSP-PA
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Other - First Name:
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Mailing Address - Street 1:1211A IRELAND DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-3372
Mailing Address - Country:US
Mailing Address - Phone:910-486-1605
Mailing Address - Fax:910-486-1590
Practice Address - Street 1:1211A IRELAND DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3372
Practice Address - Country:US
Practice Address - Phone:910-486-1605
Practice Address - Fax:910-486-1590
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC1596103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC13857OtherBCBS NC