Provider Demographics
NPI:1316121759
Name:GODASI, LISA M (LMFT)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:GODASI
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:MENTSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5509 PLEASANT VALLEY DR STE 70
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-5225
Mailing Address - Country:US
Mailing Address - Phone:719-572-6150
Mailing Address - Fax:
Practice Address - Street 1:5509 PLEASANT VALLEY DR STE 70
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-5225
Practice Address - Country:US
Practice Address - Phone:719-572-6150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-20
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO816106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist