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Individual

LISA SUSAN HALLOCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCPC

Contact information

Practice address
2124 BAY FRONT TER, ANNAPOLIS, MD 21409-5705
(773) 966-9270
Mailing address
2124 BAY FRONT TER, ANNAPOLIS, MD 21409-5705
(773) 966-9270

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
180002220
IL
101YM0800X
Mental Health Counselor
Primary
LC15565
MD

Other

Enumeration date
02/28/2025
Last updated
02/28/2025
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