Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
LISA M WALLACE, MA, LPC
ActiveLISA M WALLACE, MA, LPC is a Professional Counselor healthcare provider located in FORT COLLINS, Colorado. NPI 1124002571 is currently active in the NPPES registry. Verify at CMS.
Professional Counselor · FORT COLLINS, CO
Registration Details
- NPI Number
- 1124002571
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Nov 30, 2005 (20.521091402828 yrs)
- Last Updated
- Dec 1, 2025
- Licenses
-
906 (WY)5913 (CO)
Practice Information
- Address
-
4103 E BOARDWALK DRIVESUITE 202FORT COLLINS, CO, 805255930Browse CO providers · Browse ZIP 80525
- Phone
- 9708174049
- Fax
- 8778334460
- Primary Specialty
-
Professional Counselor
101YP2500X
- Additional Specialty
- Professional Counselor
Other Professional Counselor Providers in FORT COLLINS, CO
| Name | Credential | NPI |
|---|---|---|
| MR. GARY FARIS | LPC | 1518937549 |
| MRS. ANNE-MARIE G. SUDDRETH | LPCC | 1043288012 |
| MR. THOMAS SUTTON VNUK | MA LPC | 1205896065 |
| JAMES ALFRED SCHULTZ | L.P.C. | 1710948120 |
| DR. MARY L ATWELL | LPC | 1255392726 |
| MS. ROSHAN FAIR | LPC, MA | 1124089883 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.