Provider Demographics
NPI:1457658460
Name:GRECO, ALISA (LMHC)
Entity Type:Individual
Prefix:
First Name:ALISA
Middle Name:
Last Name:GRECO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CUMMINGS CTR STE 431G
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-6254
Mailing Address - Country:US
Mailing Address - Phone:978-223-3321
Mailing Address - Fax:978-224-1038
Practice Address - Street 1:100 CUMMINGS CTR STE 431G
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915
Practice Address - Country:US
Practice Address - Phone:978-223-3321
Practice Address - Fax:978-224-1038
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-28
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MA9147101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health