Corallo, Lisa Marie

Corallo, Lisa Marie is an individual health care provider with primary practice located at 1215 Sw G St , Grants Pass OR 97526-2544. She recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Marriage & Family Therapist, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Corallo, Lisa Marie can be contacted via phone (541) 476-2373.

Contact Information

Primary practice address
1215 Sw G St Grants Pass OR 97526-2544
Phone: (541) 476-2373
Fax: (541) 884-2338
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1659523769
LBN Legal business name Corallo, Lisa Marie
Credentials Master of Arts (MA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 21st, 2008
Last updated Oct 8th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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