Provider Demographics
NPI:1205909363
Name:SCHOTT, LISA SUSAN (LICSW)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:SUSAN
Last Name:SCHOTT
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:298 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01930-4832
Mailing Address - Country:US
Mailing Address - Phone:978-283-0296
Mailing Address - Fax:978-283-2665
Practice Address - Street 1:100 CUMMINGS CTR STE 325J
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-6119
Practice Address - Country:US
Practice Address - Phone:781-469-0924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10244361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical