MEDICARE: LISA PARISE

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
1	1041C0700X	Clinical Social Worker	0904015176	VA
2	1041C0700X	Clinical Social Worker	117563	MA

General Provider Information

NPI Number	:	1235324443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA PARISE

Provider Business Mailing Address
First Line	:	12910 GROVE HILL RD APT 101
Second Line	:
City	:	MIDLOTHIAN
State	:	VA
Zip	:	23114-5580
Country	:	US
Telephone Number	:	804-482-0477
Fax Number	:

Provider Business Practice Location Address
First Line	:	10611 PATTERSON AVE STE 301
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23238-4733
Country	:	US
Telephone Number	:	804-203-2100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/11/2007
Last Update Date	:	12/28/2023

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Directions to “ LISA PARISE ” Practice Location

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