Provider Demographics
NPI:1639350895
Name:MCCAFFERTY, LISA ANNE (LPC)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:ANNE
Last Name:MCCAFFERTY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1207 TRINITY STREET
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-2844
Mailing Address - Country:US
Mailing Address - Phone:512-466-6607
Mailing Address - Fax:833-799-3391
Practice Address - Street 1:1207 TRINITY STREET
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-2844
Practice Address - Country:US
Practice Address - Phone:512-466-6607
Practice Address - Fax:833-799-3391
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-16
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61860101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional