Provider Demographics
NPI:1790446466
Name:CONATSER, LISA N (LPC)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:N
Last Name:CONATSER
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 1:350 N STATE HIGHWAY 360 APT 10103
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-2546
Mailing Address - Country:US
Mailing Address - Phone:214-836-2315
Mailing Address - Fax:
Practice Address - Street 1:350 N STATE HIGHWAY 360 APT 10103
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-2546
Practice Address - Country:US
Practice Address - Phone:214-836-2315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-05
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78002101YM0800X, 101YP2500X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health