Provider Demographics
NPI:1265989867
Name:VRBAS-HART, LISA (MA)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:
Last Name:VRBAS-HART
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2621 5TH AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-1781
Mailing Address - Country:US
Mailing Address - Phone:308-230-0736
Mailing Address - Fax:
Practice Address - Street 1:2621 5TH AVE STE 4
Practice Address - Street 2:
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-1781
Practice Address - Country:US
Practice Address - Phone:308-230-0736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE11002101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health