Provider Demographics
NPI:1558455634
Name:SEROPIAN, LISA ANNE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:ANNE
Last Name:SEROPIAN
Suffix:
Gender:F
Credentials:PSYD
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1001 ELIZABETH AVE STE 1B
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-2234
Mailing Address - Country:US
Mailing Address - Phone:704-776-6438
Mailing Address - Fax:877-975-8238
Practice Address - Street 1:1001 ELIZABETH AVE STE 1B
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-2234
Practice Address - Country:US
Practice Address - Phone:704-776-6438
Practice Address - Fax:877-975-8238
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2135103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical