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Individual
LISA FAYE WEDGEWORTH
Active
Individual
LISA FAYE WEDGEWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, LCDC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
16850
TX
101YM0800X
Mental Health Counselor
068.0136803TELE
VT
101YP2500X
Professional Counselor
Primary
94173
TX
Other
Enumeration date
11/26/2019
Last updated
09/18/2026
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