Provider Demographics
NPI:1730905217
Name:SANCHEZ, LISA Y (LPC-MHSP)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:Y
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 MOCKINGBIRD DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-4041
Mailing Address - Country:US
Mailing Address - Phone:915-490-9140
Mailing Address - Fax:915-490-9140
Practice Address - Street 1:1129 TROTWOOD AVE STE 24
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-3046
Practice Address - Country:US
Practice Address - Phone:915-490-9140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-29
Last Update Date:2024-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6098101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional