Provider Demographics
NPI:1245908649
Name:SOREF, LISA (MSW)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:SOREF
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2228 WASHINGTON AVE APT 201
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-2636
Mailing Address - Country:US
Mailing Address - Phone:202-713-7997
Mailing Address - Fax:
Practice Address - Street 1:2228 WASHINGTON AVE APT 201
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-2636
Practice Address - Country:US
Practice Address - Phone:202-713-7997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD248221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical