Provider Demographics
NPI:1497178677
Name:ZUROLO, LISA MARIE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:MARIE
Last Name:ZUROLO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:LISA
Other - Middle Name:MARIE
Other - Last Name:DI BENEDITTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:175 CHURCH ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:NAUGATUCK
Mailing Address - State:CT
Mailing Address - Zip Code:06770-4180
Mailing Address - Country:US
Mailing Address - Phone:203-723-8546
Mailing Address - Fax:
Practice Address - Street 1:175 CHURCH ST
Practice Address - Street 2:SUITE 202
Practice Address - City:NAUGATUCK
Practice Address - State:CT
Practice Address - Zip Code:06770-4180
Practice Address - Country:US
Practice Address - Phone:203-723-8546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-24
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0055761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical