Provider Demographics
NPI:1801023833
Name:TEMPLE, LISA (MAPC, LPC)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:TEMPLE
Suffix:
Gender:F
Credentials:MAPC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8222 S 48TH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-5364
Mailing Address - Country:US
Mailing Address - Phone:480-266-8978
Mailing Address - Fax:602-368-1818
Practice Address - Street 1:8222 S 48TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-5364
Practice Address - Country:US
Practice Address - Phone:480-266-8978
Practice Address - Fax:602-368-1818
Is Sole Proprietor?:No
Enumeration Date:2009-06-17
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-13234101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional