Provider Demographics
NPI:1912006164
Name:MURRAY, LISA ANN (LPC LIC PROF COUNS)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:ANN
Last Name:MURRAY
Suffix:
Gender:F
Credentials:LPC LIC PROF COUNS
Other - Prefix:MISS
Other - First Name:LISA
Other - Middle Name:ANN
Other - Last Name:BARTLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:13614 DRAKEWOOD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247
Mailing Address - Country:US
Mailing Address - Phone:210-279-5472
Mailing Address - Fax:
Practice Address - Street 1:94 BRIGGS AVENUE
Practice Address - Street 2:SUITE 700
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78224
Practice Address - Country:US
Practice Address - Phone:210-923-0580
Practice Address - Fax:210-923-2616
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18262101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7516LCOtherBCBS OUT OF NETWK PROV