Provider Demographics
NPI:1821782939
Name:LACORTE-KRING, LISA VALERIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:VALERIE
Last Name:LACORTE-KRING
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 1:2424 NICHOLS CANYON RD.
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90046
Mailing Address - Country:US
Mailing Address - Phone:323-828-3299
Mailing Address - Fax:
Practice Address - Street 1:2424 NICHOLS CANYON RD.
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90046
Practice Address - Country:US
Practice Address - Phone:323-828-3299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW192641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty