Provider Demographics
NPI:1235372772
Name:SPARTIN, LISA ANN (LSW)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:ANN
Last Name:SPARTIN
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 SELBORNE DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19807-1215
Mailing Address - Country:US
Mailing Address - Phone:302-984-1965
Mailing Address - Fax:
Practice Address - Street 1:512 KENNETT PIKE
Practice Address - Street 2:SUITE 100
Practice Address - City:CHADDS FORD
Practice Address - State:PA
Practice Address - Zip Code:19317-9384
Practice Address - Country:US
Practice Address - Phone:302-545-7967
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-14
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW126772104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker