Provider Demographics
NPI:1598936965
Name:WASOSKI, LISA MARIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:MARIE
Last Name:WASOSKI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 CATON PL
Mailing Address - Street 2:
Mailing Address - City:BLACK MTN
Mailing Address - State:NC
Mailing Address - Zip Code:28711-3259
Mailing Address - Country:US
Mailing Address - Phone:843-725-8847
Mailing Address - Fax:
Practice Address - Street 1:30 HENDERSONVILLE RD
Practice Address - Street 2:SUITE 9
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2396
Practice Address - Country:US
Practice Address - Phone:828-442-1021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-13
Last Update Date:2016-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC89531041C0700X
NCC0094081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1598936965OtherBLUE CROSS BLUE SHIELD