Provider Demographics
NPI:1205062510
Name:CERULLO, LISA (MSW, MHS)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:
Last Name:CERULLO
Suffix:
Gender:F
Credentials:MSW, MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 GREGORY LN
Mailing Address - Street 2:
Mailing Address - City:CHESTER SPRINGS
Mailing Address - State:PA
Mailing Address - Zip Code:19425-3314
Mailing Address - Country:US
Mailing Address - Phone:610-213-4101
Mailing Address - Fax:
Practice Address - Street 1:10 GREGORY LN
Practice Address - Street 2:
Practice Address - City:CHESTER SPRINGS
Practice Address - State:PA
Practice Address - Zip Code:19425-3314
Practice Address - Country:US
Practice Address - Phone:610-213-4101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-02
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)