Provider Demographics
NPI:1871247734
Name:SANTOS, LISA M (LPC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:SANTOS
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 1:7373 N SCOTTSDALE RD STE A199
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-3593
Mailing Address - Country:US
Mailing Address - Phone:702-805-5360
Mailing Address - Fax:702-977-7488
Practice Address - Street 1:7373 N SCOTTSDALE RD STE A199
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85253-3593
Practice Address - Country:US
Practice Address - Phone:702-805-5360
Practice Address - Fax:702-977-7488
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-09
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC16402101YP2500X
AZLPC-21892101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional