Provider Demographics
NPI:1437429214
Name:FERREIRA, LISA A (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:A
Last Name:FERREIRA
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 HOPE ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-2209
Mailing Address - Country:US
Mailing Address - Phone:401-439-8153
Mailing Address - Fax:877-991-2393
Practice Address - Street 1:255 HOPE ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-2209
Practice Address - Country:US
Practice Address - Phone:401-439-8153
Practice Address - Fax:877-991-2393
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-10
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI498073OtherMHN
RILV87185Medicaid