Provider Demographics
NPI:1922510213
Name:BARELLA, LISA ANN (MS, LPCA, NCC)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:ANN
Last Name:BARELLA
Suffix:
Gender:F
Credentials:MS, LPCA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3708 COTSWOLD TER UNIT 3B
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-8955
Mailing Address - Country:US
Mailing Address - Phone:336-253-5539
Mailing Address - Fax:
Practice Address - Street 1:713 N EUGENE ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1621
Practice Address - Country:US
Practice Address - Phone:336-660-2600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-26
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA13335101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health