Healthcare Provider Details

I. General information

NPI: 1578280004
Provider Name (Legal Business Name): LISA CARR MSW, LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2022
Last Update Date: 01/13/2026
Certification Date: 01/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 MARLTON PIKE E STE 27
CHERRY HILL NJ
08034-2207
US

IV. Provider business mailing address

401 ROUTE 73 N BLDG 10, SUITE 320
MARLTON NJ
08053
US

V. Phone/Fax

Practice location:
  • Phone: 856-448-4989
  • Fax:
Mailing address:
  • Phone: 856-872-7055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW140343
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SL07203500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: