Provider Demographics
NPI:1538989827
Name:SHIELDS, LISA D (LPC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:D
Last Name:SHIELDS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 WALNUT RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15202-2030
Mailing Address - Country:US
Mailing Address - Phone:910-237-0467
Mailing Address - Fax:
Practice Address - Street 1:109 NICHOLSON RD STE C
Practice Address - Street 2:
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-9515
Practice Address - Country:US
Practice Address - Phone:910-237-0467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-12
Last Update Date:2024-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC017697101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional