Provider Demographics
NPI:1134436017
Name:LISA WOODS, LCSW
Entity type:Organization
Organization Name:LISA WOODS, LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-761-7055
Mailing Address - Street 1:4336 MORRISDALE ALLPORT HWY
Mailing Address - Street 2:
Mailing Address - City:MORRISDALE
Mailing Address - State:PA
Mailing Address - Zip Code:16858-8309
Mailing Address - Country:US
Mailing Address - Phone:814-761-7055
Mailing Address - Fax:
Practice Address - Street 1:5311 GREEN ACRE RD
Practice Address - Street 2:
Practice Address - City:HOUTZDALE
Practice Address - State:PA
Practice Address - Zip Code:16651-9428
Practice Address - Country:US
Practice Address - Phone:814-761-7055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-13
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW016490251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health