Provider Demographics
NPI:1417035726
Name:ONETO, LISA MARIE (LICSW)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:MARIE
Last Name:ONETO
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 CENTRAL ST
Mailing Address - Street 2:SUITE 218B
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-6144
Mailing Address - Country:US
Mailing Address - Phone:978-466-3553
Mailing Address - Fax:978-719-6316
Practice Address - Street 1:285 CENTRAL ST
Practice Address - Street 2:SUITE 218B
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-6144
Practice Address - Country:US
Practice Address - Phone:978-466-3553
Practice Address - Fax:978-719-6316
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10325381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP07752Medicare ID - Type Unspecified