Provider Demographics
NPI:1710310743
Name:HOPE, LISA (LCAT, ATR-BC, CASAC,)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:HOPE
Suffix:
Gender:F
Credentials:LCAT, ATR-BC, CASAC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 MAMARONECK AVE
Mailing Address - Street 2:SUITE 16
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-4217
Mailing Address - Country:US
Mailing Address - Phone:914-491-9022
Mailing Address - Fax:
Practice Address - Street 1:76 MAMARONECK AVE
Practice Address - Street 2:SUITE 16
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-4217
Practice Address - Country:US
Practice Address - Phone:914-491-9022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-13
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001643-1101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor