Provider Demographics
NPI:1649085390
Name:ZAJICEK, LISA DAWN (LMSW)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:DAWN
Last Name:ZAJICEK
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:DAWN
Other - Last Name:KOLESZAR-ZAJICEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:4903 76TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-2146
Mailing Address - Country:US
Mailing Address - Phone:806-441-1388
Mailing Address - Fax:
Practice Address - Street 1:6310 GENOA AVE
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-2706
Practice Address - Country:US
Practice Address - Phone:806-855-3050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX639001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical