Provider Demographics
NPI:1568024891
Name:LISA HAAS
Entity Type:Organization
Organization Name:LISA HAAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-812-1059
Mailing Address - Street 1:3931 STONE CANYON AVE
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-4539
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3931 STONE CANYON AVE
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-4539
Practice Address - Country:US
Practice Address - Phone:410-812-1059
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-08
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty