Provider Demographics
NPI:1336165984
Name:BEIJAN, LISA LEE (MED, LPC)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:LEE
Last Name:BEIJAN
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 DALLAS DR
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76205-7292
Mailing Address - Country:US
Mailing Address - Phone:940-565-0949
Mailing Address - Fax:940-387-3009
Practice Address - Street 1:700 DALLAS DR
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205-7292
Practice Address - Country:US
Practice Address - Phone:940-565-0949
Practice Address - Fax:940-387-3009
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15906 LPC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTX LPC 15906OtherLICENSE NUMBER
TX82863LOtherBLUE CROSS BLUE SHIELD