Provider Demographics
NPI:1902132491
Name:SEGALL, LISA JOY (LMHC)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:JOY
Last Name:SEGALL
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 NE 192ND ST APT 1009
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33180-2432
Mailing Address - Country:US
Mailing Address - Phone:954-384-1117
Mailing Address - Fax:
Practice Address - Street 1:2883 EXECUTIVE PARK DR STE 102
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3662
Practice Address - Country:US
Practice Address - Phone:954-384-1117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-19
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 10004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health