Provider Demographics
NPI:1497239198
Name:BECKER, LISA (LICSW, MSW)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:
Last Name:BECKER
Suffix:
Gender:F
Credentials:LICSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 DANIEL DR
Mailing Address - Street 2:
Mailing Address - City:WESTFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01886-1254
Mailing Address - Country:US
Mailing Address - Phone:978-728-9870
Mailing Address - Fax:
Practice Address - Street 1:8 DANIEL DR
Practice Address - Street 2:
Practice Address - City:WESTFORD
Practice Address - State:MA
Practice Address - Zip Code:01886-1254
Practice Address - Country:US
Practice Address - Phone:978-728-9870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA112047-SW-LICSW1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical