Healthcare Provider Details

I. General information

NPI: 1699681569
Provider Name (Legal Business Name): LISA MARIE PRYER LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LISA MARIE CAIAZZO

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 MARLBOROUGH RD
WEST HEMPSTEAD NY
11552-1713
US

IV. Provider business mailing address

103 MARLBOROUGH RD
WEST HEMPSTEAD NY
11552-1713
US

V. Phone/Fax

Practice location:
  • Phone: 516-317-7021
  • Fax:
Mailing address:
  • Phone: 516-317-7021
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number018346
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: