National Provider Identifier Database

LISA M POULOS
Psychiatric/Mental Health


Contact Information

LISA M POULOS
603 DOLLEY MADISON RD STE 100
GREENSBORO, NC27410-4282
Phone: 336-632-3505
Fax: 336-665-6188
Website:
Specialty Taxonomy Code
* Psychiatric/Mental Health 363LP0808X
Psychiatric/Mental Health 163WP0808X
Psychiatric/Mental Health, Child & Adolescent 364SP0807X

* Indicates primary specialty

NPI Profile & details for LISA M POULOS

NPI Number 1174561740
Credentials
Entity Individual
Enumeration date 06/03/2006
Last updated 11/14/2019 - About 7 years ago
Sole proprietor1 No
Identifiers
  • NC License #: 950023
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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