Provider Demographics
NPI:1609937077
Name:ALLEN, LISA E (LPC)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:E
Last Name:ALLEN
Suffix:
Gender:F
Credentials:LPC
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 1647
Mailing Address - Street 2:224 GREAT BRIDGE BLVD CHESAPEAKE COMMUNITY SERVICES BOA
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320
Mailing Address - Country:US
Mailing Address - Phone:757-547-9334
Mailing Address - Fax:757-819-6292
Practice Address - Street 1:224 GREAT BRIDGE BLVD
Practice Address - Street 2:CHESAPEAKE COMM SERV BOARD
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320
Practice Address - Country:US
Practice Address - Phone:757-547-9334
Practice Address - Fax:757-819-6292
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003582LPC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health