Provider Demographics
NPI:1467635078
Name:KANTOR, LISA KAPLAN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:KAPLAN
Last Name:KANTOR
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 CHURCH ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LENOX
Mailing Address - State:MA
Mailing Address - Zip Code:01240-2525
Mailing Address - Country:US
Mailing Address - Phone:413-637-3135
Mailing Address - Fax:
Practice Address - Street 1:38 CHURCH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:LENOX
Practice Address - State:MA
Practice Address - Zip Code:01240-2525
Practice Address - Country:US
Practice Address - Phone:413-637-3135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-06
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6176103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist