Provider Demographics
NPI:1851714760
Name:JONES, LISA LYNN (MA)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:LYNN
Last Name:JONES
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:LYNN
Other - Last Name:GUTTERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC, LMHC, NCC
Mailing Address - Street 1:5454 NEWCASTLE ST
Mailing Address - Street 2:APT. 1712
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-2245
Mailing Address - Country:US
Mailing Address - Phone:847-400-6003
Mailing Address - Fax:
Practice Address - Street 1:5314 DASHWOOD DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-4603
Practice Address - Country:US
Practice Address - Phone:713-600-9527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-28
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI190101YM0800X
TX6950101YP2500X
IL180.008312101YP2500X
IL178.003522101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health