Provider Demographics
NPI:1922451053
Name:BATISTA, DANISA
Entity Type:Individual
Prefix:
First Name:DANISA
Middle Name:
Last Name:BATISTA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:672 SUFFOLK ST STE 100
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01854-3659
Mailing Address - Country:US
Mailing Address - Phone:978-674-6700
Mailing Address - Fax:978-458-2733
Practice Address - Street 1:439 S UNION ST # 207A
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843
Practice Address - Country:US
Practice Address - Phone:978-681-9652
Practice Address - Fax:978-681-9654
Is Sole Proprietor?:No
Enumeration Date:2016-07-13
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1123049011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical