Provider Demographics
NPI:1336238872
Name:MACDONALD, LISA A (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:A
Last Name:MACDONALD
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 1:17 COCASSET ST
Mailing Address - Street 2:KERZNER ASSOCIATES
Mailing Address - City:FOXBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02035
Mailing Address - Country:US
Mailing Address - Phone:508-543-2133
Mailing Address - Fax:508-543-2133
Practice Address - Street 1:17 COCASSET ST
Practice Address - Street 2:KERZNER ASSOCIATES
Practice Address - City:FOXBORO
Practice Address - State:MA
Practice Address - Zip Code:02035
Practice Address - Country:US
Practice Address - Phone:508-543-2133
Practice Address - Fax:508-543-2133
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1106681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical