Provider Demographics
NPI:1588964845
Name:COUCH, LISA Y (PHD, LPC-S, LPCC)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:Y
Last Name:COUCH
Suffix:
Gender:F
Credentials:PHD, LPC-S, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 N GOLIAD ST
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-2717
Mailing Address - Country:US
Mailing Address - Phone:469-474-1146
Mailing Address - Fax:
Practice Address - Street 1:801 N GOLIAD ST
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-2717
Practice Address - Country:US
Practice Address - Phone:214-934-1499
Practice Address - Fax:972-323-3485
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-02
Last Update Date:2024-06-25
Deactivation Date:2020-04-30
Deactivation Code:
Reactivation Date:2021-04-20
Provider Licenses
StateLicense IDTaxonomies
TX64555101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional