Provider Demographics
NPI:1275009250
Name:LIMA, LISA LIOR (MSW LSW ABCDT)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:LIOR
Last Name:LIMA
Suffix:
Gender:F
Credentials:MSW LSW ABCDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 LOST LAKE DR
Mailing Address - Street 2:
Mailing Address - City:DIVIDE
Mailing Address - State:CO
Mailing Address - Zip Code:80814-9713
Mailing Address - Country:US
Mailing Address - Phone:719-626-3090
Mailing Address - Fax:
Practice Address - Street 1:37 LOST LAKE DR
Practice Address - Street 2:
Practice Address - City:DIVIDE
Practice Address - State:CO
Practice Address - Zip Code:80814-9713
Practice Address - Country:US
Practice Address - Phone:719-626-3090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-17
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLSW.00099215451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical