Provider Demographics
NPI:1023323193
Name:LISA D'ACIERNO, LCSW, LLC
Entity type:Organization
Organization Name:LISA D'ACIERNO, LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:D'ACIERNO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:201-357-2715
Mailing Address - Street 1:901 TEANECK RD
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-4511
Mailing Address - Country:US
Mailing Address - Phone:201-357-1715
Mailing Address - Fax:201-833-8858
Practice Address - Street 1:901 TEANECK RD
Practice Address - Street 2:1ST FLOOR
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4511
Practice Address - Country:US
Practice Address - Phone:201-357-1715
Practice Address - Fax:201-833-8858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-13
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJ 44SC053229001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty