Caravousanos, Lisa J

Caravousanos, Lisa J is an individual health care provider with primary practice located at 550 Montauk Hwy , Shirley NY 11967-2114. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Caravousanos, Lisa J can be contacted via phone (631) 490-3040.

Contact Information

Primary practice address
550 Montauk Hwy Shirley NY 11967-2114
Phone: (631) 490-3040
Fax: (631) 490-3055
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 072684 New York

Profile Details

NPI number 1720299167
LBN Legal business name Caravousanos, Lisa J
Credentials LCSWR
Entity Individual
Sole proprietor 1 No
Enumeration date May 25th, 2007
Last updated Jun 14th, 2024 - about 6 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720299167 NPPES
New York MEDICAID 03090140

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