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General NPI Number Information
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NPI Number | 1083851554
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Entity Type | Individual
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Provider Name | LISA PAONESSA LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/20/2009
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Last Update Date | 01/29/2009
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Provider Practice Location Address
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Address Line | 900 OSCEOLA DR STE 302A
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City | WEST PALM BEACH
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State | FL
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Zip | 33409-5075
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Country | US
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Telephone | 561-400-0654
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Fax |
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Provider Business Mailing Address
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Address Line | 15895 92ND CT N
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City | WEST PALM BEACH
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State | FL
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Zip | 33412-1741
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Country | US
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Telephone | 561-790-2026
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW9177
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License Number State | FL
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