Provider Demographics
NPI:1568792117
Name:RUPPRECHT, LISA RENAE (MA, LPC, LMFT)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:RENAE
Last Name:RUPPRECHT
Suffix:
Gender:F
Credentials:MA, LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18834 STONE OAK PKWY
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4113
Mailing Address - Country:US
Mailing Address - Phone:210-250-1449
Mailing Address - Fax:
Practice Address - Street 1:18834 STONE OAK PKWY
Practice Address - Street 2:SUITE 104
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4113
Practice Address - Country:US
Practice Address - Phone:210-250-1449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-04
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX59511101YP2500X
TX5214106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist