Provider Demographics
NPI:1245436906
Name:RAU, LISA MARIE (LPC)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:MARIE
Last Name:RAU
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 1:4733 BELINDER CT
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66205-1839
Mailing Address - Country:US
Mailing Address - Phone:816-645-8991
Mailing Address - Fax:816-470-6300
Practice Address - Street 1:212 S CAMDEN ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:MO
Practice Address - Zip Code:64085-1628
Practice Address - Country:US
Practice Address - Phone:816-470-6300
Practice Address - Fax:816-470-6301
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-21
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004032590101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional