Provider Demographics
NPI:1396049870
Name:HEXIMER, LISA (LPC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:HEXIMER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 N FRANCIS AVE
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-4114
Mailing Address - Country:US
Mailing Address - Phone:517-285-0913
Mailing Address - Fax:
Practice Address - Street 1:585 JEWETT RD
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:MI
Practice Address - Zip Code:48854-8729
Practice Address - Country:US
Practice Address - Phone:517-676-5405
Practice Address - Fax:517-676-5460
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-27
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401011878101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional