MEDICARE: LISA A DELAPLACE MSW,LCSW

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	107293	TX
2	1041C0700X	Clinical Social Worker	60793782	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447659511
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA A DELAPLACE MSW,LCSW

Provider Business Mailing Address
First Line	:	5750 GENESIS CT STE 135
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75034-4229
Country	:	US
Telephone Number	:	425-686-5631
Fax Number	:

Provider Business Practice Location Address
First Line	:	5750 GENESIS CT STE 135
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75034-4229
Country	:	US
Telephone Number	:	425-686-5631
Fax Number	:

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

Provider Enumeration Date	:	08/14/2014
Last Update Date	:	06/07/2022

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