Provider Demographics
NPI:1174997787
Name:LIND, LISSETTE (CASAC-T)
Entity type:Individual
Prefix:MRS
First Name:LISSETTE
Middle Name:
Last Name:LIND
Suffix:
Gender:F
Credentials:CASAC-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:995 FINDLAY AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10456-6102
Mailing Address - Country:US
Mailing Address - Phone:718-665-9340
Mailing Address - Fax:718-665-2394
Practice Address - Street 1:995 FINDLAY AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456-6102
Practice Address - Country:US
Practice Address - Phone:718-665-9340
Practice Address - Fax:718-665-2394
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-19
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)