Provider Demographics
NPI:1437494374
Name:ROBERTS, LISA
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:ROBERTS
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 1:1700 PINEBROOK DR STE 4
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-4365
Mailing Address - Country:US
Mailing Address - Phone:423-251-6670
Mailing Address - Fax:423-251-1899
Practice Address - Street 1:930 ADELL REE PARK LN
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-2543
Practice Address - Country:US
Practice Address - Phone:865-769-2600
Practice Address - Fax:865-769-2616
Is Sole Proprietor?:No
Enumeration Date:2012-12-04
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1758101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)