Healthcare Provider Details

I. General information

NPI: 1679388813
Provider Name (Legal Business Name): LISE-MARIE DAWN GIOVINETTI MSW, LCSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2025
Last Update Date: 05/10/2026
Certification Date: 05/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 CONSULTANT PL STE 100B
DURHAM NC
27707-3598
US

IV. Provider business mailing address

6 CONSULTANT PL STE 100B
DURHAM NC
27707-3598
US

V. Phone/Fax

Practice location:
  • Phone: 919-228-8455
  • Fax:
Mailing address:
  • Phone: 919-228-8455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP021757
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: