Provider Demographics
NPI:1992430714
Name:LOHSTROH, LISA
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:LOHSTROH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6312 THORNBRANCH DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-7905
Mailing Address - Country:US
Mailing Address - Phone:469-222-7183
Mailing Address - Fax:
Practice Address - Street 1:9555 LEBANON RD STE 502
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-6082
Practice Address - Country:US
Practice Address - Phone:214-937-9120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX87834101YM0800X
TX16074101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health