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General NPI Number Information
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NPI Number | 1235256868
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Entity Type | Organization
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Legal Business Name | LISA S LIPORACE LCSW PA
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 580 VILLAGE BLVD SUITE 210
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City | WEST PALM BEACH
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State | FL
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Zip | 33409-1904
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Country | US
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Telephone | 561-688-5030
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Fax |
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Provider Business Mailing Address
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Address Line | 402 VIA PLACITA
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33418-1727
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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 | OWNER
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Name | LISA S LIPORACE
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Credential | LCSW
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Telephone | 561-722-4531
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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 | SW3729
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License Number State | FL
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