Provider Demographics
NPI:1992093645
Name:WHEELER, LISA PLESKACH (MA, LPC, NCC)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:PLESKACH
Last Name:WHEELER
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1504 BARKSDALE BLVD
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111-4602
Mailing Address - Country:US
Mailing Address - Phone:318-222-4299
Mailing Address - Fax:318-425-2696
Practice Address - Street 1:1504 BARKSDALE BLVD
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-4602
Practice Address - Country:US
Practice Address - Phone:318-222-4299
Practice Address - Fax:318-425-2696
Is Sole Proprietor?:No
Enumeration Date:2011-07-15
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND688-6-1-11101YP2500X
LA6180101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional