Healthcare Provider Details

I. General information

NPI: 1427899624
Provider Name (Legal Business Name): LISA ANN ONORATO LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2024
Last Update Date: 06/03/2024
Certification Date: 06/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

743 HORIZON CT STE 220
GRAND JUNCTION CO
81506-8716
US

IV. Provider business mailing address

743 HORIZON CT STE 220
GRAND JUNCTION CO
81506-8716
US

V. Phone/Fax

Practice location:
  • Phone: 970-818-4940
  • Fax: 888-965-4615
Mailing address:
  • Phone: 970-818-4940
  • Fax: 888-965-4615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW138164
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: