Provider Demographics
NPI:1609985886
Name:MAYERS, LISE B (LICSW)
Entity Type:Individual
Prefix:MS
First Name:LISE
Middle Name:B
Last Name:MAYERS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 OLD POST RD
Mailing Address - Street 2:
Mailing Address - City:WESTERLY
Mailing Address - State:RI
Mailing Address - Zip Code:02891-2645
Mailing Address - Country:US
Mailing Address - Phone:401-322-0881
Mailing Address - Fax:401-322-0883
Practice Address - Street 1:35 WELLS ST UNIT 3
Practice Address - Street 2:
Practice Address - City:WESTERLY
Practice Address - State:RI
Practice Address - Zip Code:02891-2962
Practice Address - Country:US
Practice Address - Phone:401-322-0881
Practice Address - Fax:401-322-0883
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW016831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical