Provider Demographics
NPI:1053111294
Name:CORRIGAN, LISA NICOLE (LMFT TRAINEE)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:NICOLE
Last Name:CORRIGAN
Suffix:
Gender:
Credentials:LMFT TRAINEE
Other - Prefix:MS
Other - First Name:ARTEMIS
Other - Middle Name:
Other - Last Name:ABLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1012 MARKHAM PL
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95401-4902
Mailing Address - Country:US
Mailing Address - Phone:707-508-7288
Mailing Address - Fax:
Practice Address - Street 1:8695 WINDSOR RD
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CA
Practice Address - Zip Code:95492-9511
Practice Address - Country:US
Practice Address - Phone:707-508-7288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health