Individual
LISA M SOUTHERN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LMLP, LCP
Contact information
Practice address
1145 E KANSAS PLZ, GARDEN CITY, KS 67846-5870
(620) 275-0625
(620) 275-7908
Mailing address
1145 E KANSAS PLZ, GARDEN CITY, KS 67846-5870
(620) 275-0625
(620) 275-7908
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LCP 128
KS
103TB0200X
Cognitive & Behavioral Psychologist
LMLP 0495
KS
Other
Enumeration date
05/16/2006
Last updated
09/11/2025
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