MEDICARE: MS. LISA FAWCETT LCSW LP

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	102L00000X	Psychoanalyst	000226	NY
2	104100000X	Social Worker	070944	NY

General Provider Information

NPI Number	:	1316150188
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LISA FAWCETT LCSW LP

Provider Business Mailing Address
First Line	:	156 WEST 86TH ST
Second Line	:	SUITE 1A
City	:	NEW YORK CITY
State	:	NY
Zip	:	10024
Country	:	US
Telephone Number	:	212-724-6959
Fax Number	:

Provider Business Practice Location Address
First Line	:	156 WEST 86TH ST
Second Line	:	SUITE 1A
City	:	NEW YORK CITY
State	:	NY
Zip	:	10024
Country	:	US
Telephone Number	:	212-724-6959
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2007
Last Update Date	:	09/11/2025

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