Prince, Lisa D

Prince, Lisa D is an individual health care provider with primary practice located at 9111 Broadway Suite Q, Merrillville IN 46410. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Prince, Lisa D can be contacted via phone (219) 736-0003.

Contact Information

Primary practice address
9111 Broadway Suite Q Merrillville IN 46410
Phone: (219) 736-0003
Fax: (219) 756-2315
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 20041869A Indiana

Profile Details

NPI number 1801903018
LBN Legal business name Prince, Lisa D
Credentials PSYD
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 24th, 2006
Last updated Jan 17th, 2008 - about 18 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 1801903018 NPPES
Indiana Other 000000373331 ANTHEM

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