Provider Demographics
NPI:1619281359
Name:MAHER, LISA (MED, LPC)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:
Last Name:MAHER
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:MS
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:RENAUD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1501 CROCKER ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77019-4340
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1501 CROCKER ST
Practice Address - Street 2:SUITE 1
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77019-4340
Practice Address - Country:US
Practice Address - Phone:832-209-2222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-05
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61869101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional