Provider Demographics
NPI:1710301700
Name:MACCARIO, LISA (BS)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:
Last Name:MACCARIO
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 LIBERTY LN
Mailing Address - Street 2:
Mailing Address - City:NORTH READING
Mailing Address - State:MA
Mailing Address - Zip Code:01864-3223
Mailing Address - Country:US
Mailing Address - Phone:978-804-0226
Mailing Address - Fax:978-664-0419
Practice Address - Street 1:800 CUMMINS CENTER
Practice Address - Street 2:SUITE 362-U
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915
Practice Address - Country:US
Practice Address - Phone:978-998-3642
Practice Address - Fax:978-922-0098
Is Sole Proprietor?:No
Enumeration Date:2014-02-11
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health