Provider Demographics
NPI:1073175428
Name:HAMADA, LISA DANIELLE (LMHC)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:DANIELLE
Last Name:HAMADA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:DANIELLE
Other - Last Name:SARNO-HAMADA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:15 VISTA DR
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11768-1923
Mailing Address - Country:US
Mailing Address - Phone:631-935-2742
Mailing Address - Fax:
Practice Address - Street 1:15 VISTA DR
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11768-1923
Practice Address - Country:US
Practice Address - Phone:631-935-2742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-06
Last Update Date:2019-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002136-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health