Provider Demographics
NPI:1174582480
Name:JOBIN, LISA D (LCMHC, MLADC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:D
Last Name:JOBIN
Suffix:
Gender:F
Credentials:LCMHC, MLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 TARRYTOWN RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-2713
Mailing Address - Country:US
Mailing Address - Phone:603-663-4430
Mailing Address - Fax:603-269-2232
Practice Address - Street 1:140 TARRYTOWN RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-2713
Practice Address - Country:US
Practice Address - Phone:603-663-4430
Practice Address - Fax:603-269-2232
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1025101YA0400X
NH580101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30423369Medicaid
NH2129961OtherCIGNA BH PIN
NH14Y008254NH01OtherANTHEM ACES #
NH387283OtherMVP PIN