Provider Demographics
NPI:1255753539
Name:LAHR, LISA MARIE (MA, IADC, LMHC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:MARIE
Last Name:LAHR
Suffix:
Gender:F
Credentials:MA, IADC, LMHC
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:MARIE
Other - Last Name:BISCHOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, IADC, LMHC
Mailing Address - Street 1:1340 BLAIRS FERRY RD STE 1
Mailing Address - Street 2:
Mailing Address - City:HIAWATHA
Mailing Address - State:IA
Mailing Address - Zip Code:52233-1900
Mailing Address - Country:US
Mailing Address - Phone:319-398-6641
Mailing Address - Fax:319-369-4673
Practice Address - Street 1:1340 BLAIRS FERRY RD STE 1
Practice Address - Street 2:
Practice Address - City:HIAWATHA
Practice Address - State:IA
Practice Address - Zip Code:52233-1900
Practice Address - Country:US
Practice Address - Phone:319-398-6641
Practice Address - Fax:319-369-4673
Is Sole Proprietor?:No
Enumeration Date:2014-01-06
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001582101YM0800X
IA15067101YA0400X
IA20768101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional