Healthcare Provider Details

I. General information

NPI: 1285932780
Provider Name (Legal Business Name): LISA CHRISTINE SPITTAL LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2011
Last Update Date: 02/08/2026
Certification Date: 02/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1081 MAIN ST STE G
FISHKILL NY
12524-3505
US

IV. Provider business mailing address

64 LAKE SHORE RD
PUTNAM VALLEY NY
10579-1342
US

V. Phone/Fax

Practice location:
  • Phone: 845-208-4885
  • Fax:
Mailing address:
  • Phone: 914-582-2936
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number089845
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: