Provider Demographics
NPI:1942853759
Name:RICHARDSON, LISSA LEE (LPC)
Entity Type:Individual
Prefix:MS
First Name:LISSA
Middle Name:LEE
Last Name:RICHARDSON
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 1:9 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:RINGOES
Mailing Address - State:NJ
Mailing Address - Zip Code:08551-1226
Mailing Address - Country:US
Mailing Address - Phone:908-752-0068
Mailing Address - Fax:
Practice Address - Street 1:9 LAKEVIEW DR
Practice Address - Street 2:
Practice Address - City:RINGOES
Practice Address - State:NJ
Practice Address - Zip Code:08551-1226
Practice Address - Country:US
Practice Address - Phone:908-752-0068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-20
Last Update Date:2019-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00116000101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional