| Provider / Organization | NPI | Date Certified |
|---|---|---|
| LISA STURDIVANT | 1225637671 | 2021-04-07 |
Lisa Sturdivant is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1225637671. Registration indicates Lisa Sturdivant is a provider of services with a specialization in Behavioral Health & Social Service Providers, Marriage & Family Therapist (Marriage & Family Therapist, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Marriage & Family Therapist, Behavioral Health & Social Service Providers) Access to Mental Health/Behavioral Health Providers (Behavioral Health & Social Service Providers, Counselor) (Behavioral Health & Social Service Providers, Counselor) (Counselor: Mental Health, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Counselor Mental Health, Behavioral Health & Social Service Providers) (Counselor, )
| Entity Type | Individual |
| Provider Name | Lisa Sturdivant |
| Practice Office Address | 21900 WILLAMETTE DR STE 202 WEST LINN, OR US |
| Practice Office Telephone | 5037899733 |
| Mailing Address | 21900 WILLAMETTE DR STE 202 WEST LINN, OR 970683284 US |
| Business Telephone | 5036530631 |
| Business Fax | 5036531464 |
| Code | Practice | License No State |
|---|---|---|
| 106H00000X | Behavioral Health & Social Service Providers Marriage & Family Therapist Marriage & Family Therapist Behavioral Health/Substance Abuse/Psychiatry Marriage & Family Therapist Behavioral Health & Social Service Providers | R4829
OR |
| 101YM0800X PRIMARY | Access to Mental Health/Behavioral Health Providers Behavioral Health & Social Service Providers Counselor Behavioral Health & Social Service Providers Counselor Counselor: Mental Health Behavioral Health/Substance Abuse/Psychiatry Counselor Mental Health Behavioral Health & Social Service Providers Counselor | R6173
OR |