Provider Demographics
NPI:1598031080
Name:WARREN, LISA Z (PHD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:Z
Last Name:WARREN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 S BELL BLVD STE 406
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-3977
Mailing Address - Country:US
Mailing Address - Phone:512-852-8020
Mailing Address - Fax:512-551-0100
Practice Address - Street 1:930 S BELL BLVD STE 406
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-3977
Practice Address - Country:US
Practice Address - Phone:512-852-8020
Practice Address - Fax:512-551-0100
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-28
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.007190103TB0200X, 103TC2200X, 103TC0700X
TX37291103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent