| Lisa Dyck Lmft | |
|
31324 Via Colinas Ste 108 Westlake Village CA 91362-6756 | |
| (805) 660-0932 | |
| (818) 889-1815 |
| Full Name | Lisa Dyck Lmft |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 31324 Via Colinas Ste 108, Westlake Village, California |
| Authorized Official Name and Position | Lisa Marie Dyck (PRESIDENT AND CEO) |
| Authorized Official Contact | 8056600932 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa Dyck Lmft 31324 Via Colinas Ste 108 Westlake Village CA 91362-6756 Ph: (805) 660-0932 | Lisa Dyck Lmft 31324 Via Colinas Ste 108 Westlake Village CA 91362-6756 Ph: (805) 660-0932 |
| NPI Number | 1568853232 |
|---|---|
| Provider Enumeration Date | 02/16/2015 |
| Last Update Date | 02/16/2024 |
| Certification Date | 02/16/2024 |
| Medicare PECOS PAC ID | 8325485717 |
|---|---|
| Medicare Enrollment ID | O20240320004119 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568853232 | NPI | - | NPPES |
| 11051966 | Other | CA | DOB |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 84472 (California) | Primary |
| Provider Name | Lisa Marie Dyck |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1750770186 PECOS PAC ID: 9234576620 Enrollment ID: I20240320004126 |
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