Individual
LISA WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC, LCADC
Contact information
Practice address
8101 SANDY SPRING RD STE 300, LAUREL, MD 20707-3596
(240) 459-8517
Mailing address
8101 SANDY SPRING RD STE 300, LAUREL, MD 20707-3596
(240) 459-8517
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LCA402
MD
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCA402
MD
101YP2500X
Professional Counselor
Primary
LC12800
MD
Other
Enumeration date
03/03/2011
Last updated
05/01/2024
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