Provider Demographics
NPI:1639835044
Name:LISA COVENEY, LICSW, LLC
Entity Type:Organization
Organization Name:LISA COVENEY, LICSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:COVENEY
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LICSW
Authorized Official - Phone:781-588-8159
Mailing Address - Street 1:260 WASHINGTON ST STE 2-2
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:MA
Mailing Address - Zip Code:02359-1805
Mailing Address - Country:US
Mailing Address - Phone:781-588-8159
Mailing Address - Fax:
Practice Address - Street 1:260 WASHINGTON ST STE 2-2
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:MA
Practice Address - Zip Code:02359-1805
Practice Address - Country:US
Practice Address - Phone:781-588-8159
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-10
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical