MEDICARE: LISA S LIPORACE LCSW PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	SW3729	FL

General Provider Information

NPI Number	:	1235256868
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LISA S LIPORACE LCSW PA

Provider Business Mailing Address
First Line	:	402 VIA PLACITA
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-1727
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	580 VILLAGE BLVD
Second Line	:	SUITE 210
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-1904
Country	:	US
Telephone Number	:	561-688-5030
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LISA S LIPORACE
Credential	:	LCSW
Telephone Number	:	561-722-4531

Provider Enumeration Date	:	03/26/2007
Last Update Date	:	08/22/2020

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