Provider Demographics
NPI:1245689496
Name:MONTUORI, LISA MARIE (LMHC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:MARIE
Last Name:MONTUORI
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:MARIE
Other - Last Name:MONTUORI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:15 MORNINGSIDE DR
Mailing Address - Street 2:
Mailing Address - City:ROCKLAND
Mailing Address - State:MA
Mailing Address - Zip Code:02370-2797
Mailing Address - Country:US
Mailing Address - Phone:617-835-7663
Mailing Address - Fax:
Practice Address - Street 1:15 MORNINGSIDE DR
Practice Address - Street 2:
Practice Address - City:ROCKLAND
Practice Address - State:MA
Practice Address - Zip Code:02370-2797
Practice Address - Country:US
Practice Address - Phone:617-835-7663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-08
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
MA9720101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9720OtherLICENSE NUMBER