Provider Demographics
NPI:1942729371
Name:ALBERTY, LISA MARIE
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:MARIE
Last Name:ALBERTY
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 1:120 BENCHLEY PL APT 33J
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-3424
Mailing Address - Country:US
Mailing Address - Phone:646-409-2915
Mailing Address - Fax:
Practice Address - Street 1:2510 WESTCHESTER AVE STE 202
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-3585
Practice Address - Country:US
Practice Address - Phone:855-400-1975
Practice Address - Fax:646-351-8517
Is Sole Proprietor?:No
Enumeration Date:2017-09-18
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0943641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical