Provider Demographics
NPI:1881885952
Name:DRUKER, LISA K (LCSW)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:K
Last Name:DRUKER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 E PUTNAM AVE # 2E
Mailing Address - Street 2:
Mailing Address - City:COS COB
Mailing Address - State:CT
Mailing Address - Zip Code:06807-2744
Mailing Address - Country:US
Mailing Address - Phone:203-912-9800
Mailing Address - Fax:203-869-9221
Practice Address - Street 1:132 E PUTNAM AVE # 2E
Practice Address - Street 2:
Practice Address - City:COS COB
Practice Address - State:CT
Practice Address - Zip Code:06807-2744
Practice Address - Country:US
Practice Address - Phone:203-912-9800
Practice Address - Fax:203-869-9221
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0058451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical