Provider Demographics
NPI:1114261831
Name:LISA PLOTKIN, LCSW, PC
Entity Type:Organization
Organization Name:LISA PLOTKIN, LCSW, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:PLOTKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-350-5329
Mailing Address - Street 1:230 BITTERSWEET DR
Mailing Address - Street 2:
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-1609
Mailing Address - Country:US
Mailing Address - Phone:717-350-5329
Mailing Address - Fax:717-520-2526
Practice Address - Street 1:561 W CHOCOLATE AVE
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-1676
Practice Address - Country:US
Practice Address - Phone:717-350-5329
Practice Address - Fax:717-520-2526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACWO127251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty