Individual
LISA LYN HARGROVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMHC, LCAS
Contact information
Practice address
235 SUGAR MAPLE AVE, WAKE FOREST, NC 27587-2280
(919) 593-5445
Mailing address
235 SUGAR MAPLE AVE, WAKE FOREST, NC 27587-2280
(919) 593-5445
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
21906
NC
101YM0800X
Mental Health Counselor
068.0135520TELE
VT
101YP2500X
Professional Counselor
Primary
12065
NC
Other
Enumeration date
05/16/2016
Last updated
07/02/2025
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