Provider Demographics
NPI:1336229525
Name:PATTERSON, LISA MARIA (LPC LMHC)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:MARIA
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:LPC LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1113 SANFORD RD
Mailing Address - Street 2:
Mailing Address - City:ANDALUSIA
Mailing Address - State:AL
Mailing Address - Zip Code:36420-4151
Mailing Address - Country:US
Mailing Address - Phone:334-488-5959
Mailing Address - Fax:
Practice Address - Street 1:125 MEDICAL PARK DR STE 103
Practice Address - Street 2:
Practice Address - City:ANDALUSIA
Practice Address - State:AL
Practice Address - Zip Code:36420-5302
Practice Address - Country:US
Practice Address - Phone:334-488-5959
Practice Address - Fax:334-222-1995
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2072 LPC101YM0800X
FLMH 10733101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health