Provider Demographics
NPI:1730319401
Name:IMPERIALE, LISA ROBIN (LSW)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:ROBIN
Last Name:IMPERIALE
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 GERMANTOWN PIKE
Mailing Address - Street 2:SUITE D
Mailing Address - City:LAFAYETTE HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19444-1800
Mailing Address - Country:US
Mailing Address - Phone:610-825-4450
Mailing Address - Fax:
Practice Address - Street 1:600 GERMANTOWN PIKE
Practice Address - Street 2:SUITE D
Practice Address - City:LAFAYETTE HILL
Practice Address - State:PA
Practice Address - Zip Code:19444-1800
Practice Address - Country:US
Practice Address - Phone:610-825-4450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-16
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW1223381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical