| Doctor Name: | LISA MOHAWK |
| NPI Number: | 1063731917 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC, CSAC |
| License Number: | 15441-132 |
| Business Practice Address: | W12802 County Hwy A Bowler, WI - 54416 |
| Business Phone Number: | 7157933000 |
| Business Fax Number: | 7157931312 |
| Mailing Address: | 8896 Sandalwood Ct, WOODRUFF |
| State: | WI |
| Postal Code: | 545689339 |
| Phone Number: | 7155840440 |
| Fax Number: | |
| NPI Enumeration Date: | 05/18/2010 |
| NPI Last Update Date: | 11/02/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 15441-132 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |