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General NPI Number Information
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NPI Number | 1639835044
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Entity Type | Organization
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Legal Business Name | LISA COVENEY, LICSW, LLC
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Dates
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Enumeration Date | 11/10/2021
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Last Update Date | 11/21/2023
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Provider Practice Location Address
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Address Line | 260 WASHINGTON ST STE 2-2
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City | PEMBROKE
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State | MA
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Zip | 02359-1805
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Country | US
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Telephone | 781-588-8159
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Fax |
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Provider Business Mailing Address
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Address Line | 260 WASHINGTON ST STE 2-2
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City | PEMBROKE
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State | MA
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Zip | 02359-1805
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Country | US
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Telephone | 781-588-8159
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | LISA COVENEY
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Credential | MSW, LICSW
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Telephone | 781-588-8159
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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 |
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License Number State |
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