Provider Demographics
NPI:1659419984
Name:CELIBERTI, LISA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:
Last Name:CELIBERTI
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 1:377 POND PATH
Mailing Address - Street 2:
Mailing Address - City:SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-1020
Mailing Address - Country:US
Mailing Address - Phone:631-338-0708
Mailing Address - Fax:631-689-2007
Practice Address - Street 1:377 POND PATH
Practice Address - Street 2:
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-1020
Practice Address - Country:US
Practice Address - Phone:631-338-0708
Practice Address - Fax:631-689-2007
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0402151NY104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY60054OtherAETNA
NYSX173OtherVALUE OPTIONS
NYP3086836OtherOXFORD
NYSB803OtherBCBS
NY11303OtherMAGNACARE
NY87726OtherUNITED HEALTH CARE
NY138975OtherVALUE OPTIONS
NYN403K1OtherEMPIRE BC/BS