Provider Demographics
NPI:1598845703
Name:SINGLETON, LISHA D'NEILLE (MFT)
Entity Type:Individual
Prefix:
First Name:LISHA
Middle Name:D'NEILLE
Last Name:SINGLETON
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1726
Mailing Address - Street 2:
Mailing Address - City:MONROVIA
Mailing Address - State:CA
Mailing Address - Zip Code:91017
Mailing Address - Country:US
Mailing Address - Phone:972-955-5531
Mailing Address - Fax:626-357-8335
Practice Address - Street 1:37 N. AUBURN
Practice Address - Street 2:STE 2
Practice Address - City:SIERRA MADRE
Practice Address - State:CA
Practice Address - Zip Code:91024
Practice Address - Country:US
Practice Address - Phone:972-955-5531
Practice Address - Fax:626-357-8335
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4867106H00000X
CA31151106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1737058-01Medicaid
TX173705801Medicaid