Provider Demographics
NPI:1508269127
Name:WINKLER, LISA (LCSW-C)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:WINKLER
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10632 PRINCESS DIANA CT
Mailing Address - Street 2:
Mailing Address - City:LA PLATA
Mailing Address - State:MD
Mailing Address - Zip Code:20646-3805
Mailing Address - Country:US
Mailing Address - Phone:301-475-4200
Mailing Address - Fax:301-475-4132
Practice Address - Street 1:47149 BUSE RD BLDG 1370
Practice Address - Street 2:
Practice Address - City:PATUXENT RIVER
Practice Address - State:MD
Practice Address - Zip Code:20670-1540
Practice Address - Country:US
Practice Address - Phone:301-995-3858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-28
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
508110101YA0400X
VA09040071571041C0700X
MD113751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)