Provider Demographics
NPI:1568435840
Name:LAHAIE, LISA A (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:A
Last Name:LAHAIE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:500 N US HIGHWAY 89
Mailing Address - Street 2:NORTHERN ARIZONA VA HCS
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86313
Mailing Address - Country:US
Mailing Address - Phone:928-445-4860
Mailing Address - Fax:928-776-6125
Practice Address - Street 1:500 N US HIGHWAY 89
Practice Address - Street 2:NORTHERN ARIZONA VA HCS (NAVAHCS)
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86313
Practice Address - Country:US
Practice Address - Phone:928-445-4860
Practice Address - Fax:928-776-6125
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ139891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical