Provider Demographics
NPI:1962231647
Name:NOLAND, LISA
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:NOLAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:POSTLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4414 DUBLIN HILL RD
Mailing Address - Street 2:
Mailing Address - City:BRIDGEVILLE
Mailing Address - State:DE
Mailing Address - Zip Code:19933-2733
Mailing Address - Country:US
Mailing Address - Phone:215-200-4088
Mailing Address - Fax:
Practice Address - Street 1:1310 MIDDLEFORD RD STE 102
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-3670
Practice Address - Country:US
Practice Address - Phone:302-612-4012
Practice Address - Fax:302-612-4062
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-30
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEAC-0010347101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health