Provider Demographics
NPI:1518443407
Name:PHILLIPS, LIONNETTE LASHAWN
Entity Type:Individual
Prefix:MRS
First Name:LIONNETTE
Middle Name:LASHAWN
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4827 VICTORIA DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-4043
Mailing Address - Country:US
Mailing Address - Phone:318-451-7197
Mailing Address - Fax:
Practice Address - Street 1:4827 VICTORIA DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-4043
Practice Address - Country:US
Practice Address - Phone:318-451-7197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-14
Last Update Date:2018-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health