Provider Demographics
NPI:1386781698
Name:ORRICK, LISA GOHMANN (LPC)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:GOHMANN
Last Name:ORRICK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:GOHMANN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:357 RIVERSIDE DR
Mailing Address - Street 2:STE. 101
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-8963
Mailing Address - Country:US
Mailing Address - Phone:615-400-6577
Mailing Address - Fax:
Practice Address - Street 1:357 RIVERSIDE DR
Practice Address - Street 2:STE. 101
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-8963
Practice Address - Country:US
Practice Address - Phone:615-400-6577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000001731101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional