Provider Demographics
NPI:1093729683
Name:PORTO NOTO, LISA ANN (MSW, LCSW, LCSW-C)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:ANN
Last Name:PORTO NOTO
Suffix:
Gender:F
Credentials:MSW, LCSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7643 LEESBURG PIKE
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22043-2530
Mailing Address - Country:US
Mailing Address - Phone:703-967-0221
Mailing Address - Fax:703-790-9257
Practice Address - Street 1:7643 LEESBURG PIKE
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22043-2530
Practice Address - Country:US
Practice Address - Phone:703-967-0221
Practice Address - Fax:703-790-9257
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040039421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical