Provider Demographics
NPI:1700646478
Name:SMITH, LISA A
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:A
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5990 GREENWOOD PLAZA BLVD STE 2
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4704
Mailing Address - Country:US
Mailing Address - Phone:720-377-1359
Mailing Address - Fax:
Practice Address - Street 1:5990 GREENWOOD PLAZA BLVD STE 2
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-4704
Practice Address - Country:US
Practice Address - Phone:720-377-1359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health