Provider Demographics
NPI:1518459205
Name:L & A PROFESSIONAL SERVICES, LLC
Entity Type:Organization
Organization Name:L & A PROFESSIONAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:A
Authorized Official - Last Name:WINES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC
Authorized Official - Phone:832-683-4275
Mailing Address - Street 1:PO BOX 2453
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77410-2453
Mailing Address - Country:US
Mailing Address - Phone:832-683-4275
Mailing Address - Fax:832-683-4267
Practice Address - Street 1:17240 HUFFMEISTER RD STE 104
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-4694
Practice Address - Country:US
Practice Address - Phone:832-683-4275
Practice Address - Fax:832-683-4267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-30
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69929101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty