Provider Demographics
NPI:1144662586
Name:SAN MIGUEL, LISA F (LMSW)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:F
Last Name:SAN MIGUEL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1950
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77487-1950
Mailing Address - Country:US
Mailing Address - Phone:832-366-5980
Mailing Address - Fax:
Practice Address - Street 1:4850 W BELLFORT AVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77035-3413
Practice Address - Country:US
Practice Address - Phone:137-237-3135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-26
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX578591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical