Provider Demographics
NPI:1144629213
Name:GALEUCIA, LISA LAWRENCE (LMHC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:LAWRENCE
Last Name:GALEUCIA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:MARIE
Other - Last Name:ELROD-LAWRENCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:195 NE GILMAN BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-2940
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:195 NE GILMAN BLVD STE 100
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-2940
Practice Address - Country:US
Practice Address - Phone:425-295-7697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-14
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health