Burnham, Lisa Jane

Burnham, Lisa Jane is an individual health care provider with primary practice located at 115 5Th Ave S Ste 504 , La Crosse WI 54601-4079. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Burnham, Lisa Jane can be contacted via phone (715) 896-4772.

Contact Information

Primary practice address
115 5Th Ave S Ste 504 La Crosse WI 54601-4079
Phone: (715) 896-4772
Fax: (608) 782-4426
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 16199-132 Wisconsin
Behavioral Health & Social Service Providers / Professional 101YP2500X 3803-226 Wisconsin

Profile Details

NPI number 1801244025
LBN Legal business name Burnham, Lisa Jane
Credentials CSAC, LPC-IT
Entity Individual
Sole proprietor 1 No
Enumeration date May 27th, 2016
Last updated Jan 20th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801244025 NPPES
Wisconsin MEDICAID 100060087

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