Provider Demographics
NPI:1396035093
Name:BILLINGS, LISA L (PHD)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:L
Last Name:BILLINGS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6065 S QUEBEC ST STE 202
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4532
Mailing Address - Country:US
Mailing Address - Phone:303-946-6495
Mailing Address - Fax:303-779-0327
Practice Address - Street 1:6065 S QUEBEC ST STE 202
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80111-4532
Practice Address - Country:US
Practice Address - Phone:303-946-6495
Practice Address - Fax:303-779-0327
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-14
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3214103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical