Provider Demographics
NPI:1528506110
Name:HOOVER, LISA (LPC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:HOOVER
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 1:6735 CUTTY SARK ST
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99502-1945
Mailing Address - Country:US
Mailing Address - Phone:907-575-5926
Mailing Address - Fax:855-978-1475
Practice Address - Street 1:3150 C ST STE 270
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-3982
Practice Address - Country:US
Practice Address - Phone:907-575-5926
Practice Address - Fax:855-978-1475
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-03
Last Update Date:2024-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
CA4182101YM0800X
AK192840101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)