Provider Demographics
NPI:1194333401
Name:PATRIZIA, LISA (LPC, LPCC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:PATRIZIA
Suffix:
Gender:F
Credentials:LPC, LPCC
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:MONDORO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:509 PARK ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22902-4739
Mailing Address - Country:US
Mailing Address - Phone:434-202-3501
Mailing Address - Fax:
Practice Address - Street 1:509 PARK ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22902-4739
Practice Address - Country:US
Practice Address - Phone:434-466-2435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-22
Last Update Date:2024-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALPCC8418101YM0800X
VA0701007236101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health