Provider Demographics
NPI:1952035396
Name:CLOUZET, LISA LYNN (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:LYNN
Last Name:CLOUZET
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4891 SUNKIST TER
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-6850
Mailing Address - Country:US
Mailing Address - Phone:423-602-6533
Mailing Address - Fax:
Practice Address - Street 1:4891 SUNKIST TER
Practice Address - Street 2:
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-6850
Practice Address - Country:US
Practice Address - Phone:423-602-6533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1655101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health