Provider Demographics
NPI:1790301505
Name:LISA PHILIPPART LPC LLC
Entity Type:Organization
Organization Name:LISA PHILIPPART LPC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:PHILIPPART
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:256-326-0909
Mailing Address - Street 1:540 HUGHES RD STE 10A
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-8936
Mailing Address - Country:US
Mailing Address - Phone:256-631-7898
Mailing Address - Fax:
Practice Address - Street 1:540 HUGHES RD STE 10A
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-8936
Practice Address - Country:US
Practice Address - Phone:256-631-7898
Practice Address - Fax:256-542-3366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-18
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health