Provider Demographics
NPI:1144934498
Name:MCBRIDE, LISA (LPC-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2086 PORTER RD APT 7102
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77301-5171
Mailing Address - Country:US
Mailing Address - Phone:281-949-0759
Mailing Address - Fax:
Practice Address - Street 1:2086 PORTER RD APT 7102
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77301-5171
Practice Address - Country:US
Practice Address - Phone:281-949-0759
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-11
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX90617101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health