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Individual

LISA BOURNE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
261 NORTH ST, BRISTOL, VA 24201-3275
(276) 821-8030
(423) 900-2435
Mailing address
28187 OSCEOLA RD, ABINGDON, VA 24211-6400
(276) 698-4582

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
0701006880
VA
101YA0400X
Addiction (Substance Use Disorder) Counselor
0710103678
VA
101YA0400X
Addiction (Substance Use Disorder) Counselor
0718000721
VA
101YP2500X
Professional Counselor
Primary
0701006880
VA

Other

Enumeration date
12/15/2016
Last updated
06/24/2025
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