Provider Demographics
NPI:1275924193
Name:PIERCE, LISA J (MA, LMHC, LCPC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:J
Last Name:PIERCE
Suffix:
Gender:
Credentials:MA, LMHC, LCPC
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:J
Other - Last Name:PIERCE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:784 S CLEARWATER LOOP, STE 8049
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-9599
Mailing Address - Country:US
Mailing Address - Phone:206-317-1200
Mailing Address - Fax:206-316-8399
Practice Address - Street 1:784 S CLEARWATER LOOP, STE 8049
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-9599
Practice Address - Country:US
Practice Address - Phone:206-317-1200
Practice Address - Fax:206-316-8399
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-13
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60877931101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty