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General NPI Number Information
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NPI Number | 1194644971
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Entity Type | Individual
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Provider Name | LISA VICENTE LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/14/2026
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Last Update Date | 07/14/2026
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Provider Practice Location Address
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Address Line | 476 BROADWAY
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City | METHUEN
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State | MA
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Zip | 01844-2048
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Country | US
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Telephone | 978-945-1627
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Fax |
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Provider Business Mailing Address
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Address Line | 88 EDGELAWN AVE APT 9
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City | NORTH ANDOVER
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State | MA
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Zip | 01845-4473
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Country | US
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Telephone |
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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 | LCSW2143942
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License Number State | MA
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