Provider Demographics
NPI:1902822489
Name:LENTINO, LISA MANZI (PHD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:MANZI
Last Name:LENTINO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 BOSTON POST RD
Mailing Address - Street 2:
Mailing Address - City:SUDBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01776-3016
Mailing Address - Country:US
Mailing Address - Phone:978-443-5611
Mailing Address - Fax:
Practice Address - Street 1:416 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:SUDBURY
Practice Address - State:MA
Practice Address - Zip Code:01776-3016
Practice Address - Country:US
Practice Address - Phone:978-443-5611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7893103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW06068OtherBLUE CROSS BLUE SHIELD
MA2115855OtherCIGNA BEHAVIORAL HEALTH
MA2115855OtherCIGNA BEHAVIORAL HEALTH