Provider Demographics
NPI:1033503628
Name:ZITO, LISA (LISW-S, CDCA)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:ZITO
Suffix:
Gender:F
Credentials:LISW-S, CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1329 E KEMPER RD STE 4220A
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:OH
Mailing Address - Zip Code:45246-5100
Mailing Address - Country:US
Mailing Address - Phone:513-970-9522
Mailing Address - Fax:513-436-0687
Practice Address - Street 1:1329 E KEMPER RD STE 4220A
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:OH
Practice Address - Zip Code:45246-5100
Practice Address - Country:US
Practice Address - Phone:513-970-9522
Practice Address - Fax:513-436-0687
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-23
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.1700466104100000X, 1041C0700X
101YA0400X
OHI.1700466-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)