Provider Demographics
NPI:1710935531
Name:HEMMINGSON, LISA ANN (MA)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:ANN
Last Name:HEMMINGSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 S SYCAMORE AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57110-4263
Mailing Address - Country:US
Mailing Address - Phone:605-271-0261
Mailing Address - Fax:605-271-0263
Practice Address - Street 1:2000 S SYCAMORE AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57110-4263
Practice Address - Country:US
Practice Address - Phone:605-271-0261
Practice Address - Fax:605-271-0263
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC1070101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health