Provider Demographics
NPI:1184893786
Name:GAUGHRAN, LISA (PHD, LMHC)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:
Last Name:GAUGHRAN
Suffix:
Gender:F
Credentials:PHD, LMHC
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 117
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01004-0117
Mailing Address - Country:US
Mailing Address - Phone:413-253-9928
Mailing Address - Fax:
Practice Address - Street 1:37 S PLEASANT ST
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-2238
Practice Address - Country:US
Practice Address - Phone:413-253-9928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-27
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4426101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health