Provider Demographics
NPI:1386859247
Name:EISENBERG, LISA (LMSW)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:
Last Name:EISENBERG
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2843 PEWTER MIST CT
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-5976
Mailing Address - Country:US
Mailing Address - Phone:917-797-6007
Mailing Address - Fax:
Practice Address - Street 1:2843 PEWTER MIST CT
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-5976
Practice Address - Country:US
Practice Address - Phone:917-797-6007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY072678104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker