Provider Demographics
NPI:1124498258
Name:BATRES, LISA BETH (LCSW)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:BETH
Last Name:BATRES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2439 TOWN LAKE CIR APT 310
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78741-3031
Mailing Address - Country:US
Mailing Address - Phone:571-201-0285
Mailing Address - Fax:
Practice Address - Street 1:2439 TOWN LAKE CIR APT 310
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78741-3031
Practice Address - Country:US
Practice Address - Phone:703-249-9614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-01
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09030024961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1303295Medicaid
MA1307576Medicaid
MAM18463OtherBLUE CROSS BLUE SHIELD
MA1303295Medicaid