Provider Demographics
NPI:1861702672
Name:LISA A. SEROPIAN, PSY.D., P.A.
Entity type:Organization
Organization Name:LISA A. SEROPIAN, PSY.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:SEROPIAN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:704-776-6438
Mailing Address - Street 1:1001 ELIZABETH AVE STE 1B
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-2234
Mailing Address - Country:US
Mailing Address - Phone:704-776-6438
Mailing Address - Fax:877-975-8238
Practice Address - Street 1:1001 ELIZABETH AVE STE 1B
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-2234
Practice Address - Country:US
Practice Address - Phone:704-776-6438
Practice Address - Fax:877-975-8238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-14
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2135103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty