Gonzalez, Lisa

Gonzalez, Lisa is an individual health care provider with primary practice located at 501 W 14Th St , Wilmington DE 19801-1013. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Gonzalez, Lisa can be contacted via phone (302) 428-2987.

Contact Information

Primary practice address
501 W 14Th St Wilmington DE 19801-1013
Phone: (302) 428-2987
Fax: (302) 428-2984
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 37LC00160100 New Jersey
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 37CA00046700 New Jersey
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X CD-0000078 Delaware

Profile Details

NPI number 1346373206
LBN Legal business name Gonzalez, Lisa
Credentials MS, LCDP
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 13th, 2007
Last updated Mar 8th, 2016 - about 9 years 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 1346373206 NPPES
New Jersey MEDICAID 0077313

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