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NPI Code Detail

MEDICARE: MRS. LISSETTE LIND CASAC-T

MEDICARE:  MRS. LISSETTE  LIND  CASAC-T
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1174997787
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LISSETTE LIND CASAC-T
Provider Business Mailing Address
First Line : 995 FINDLAY AVE
Second Line :
City : BRONX
State : NY
Zip : 10456-6102
Country : US
Telephone Number : 718-665-9340
Fax Number : 718-665-2394
Provider Business Practice Location Address
First Line : 995 FINDLAY AVE
Second Line :
City : BRONX
State : NY
Zip : 10456-6102
Country : US
Telephone Number : 718-665-9340
Fax Number : 718-665-2394
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/19/2015
Last Update Date : 11/19/2015

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Directions to “ MRS. LISSETTE LIND CASAC-T” Practice Location

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