Provider Demographics
NPI:1659654846
Name:FRITZ, LISA R (LCSW)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:R
Last Name:FRITZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:R
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:540 NORTH DUKE STREET
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2208
Mailing Address - Country:US
Mailing Address - Phone:717-560-3782
Mailing Address - Fax:717-560-3787
Practice Address - Street 1:540 NORTH DUKE STREET
Practice Address - Street 2:3RD FLOOR
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2208
Practice Address - Country:US
Practice Address - Phone:717-560-3782
Practice Address - Fax:717-560-3787
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-23
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW128848104100000X
PACW0198821041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical