Provider Demographics
NPI:1063808210
Name:HARRINGTON, LISA C (APRN, PLC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:C
Last Name:HARRINGTON
Suffix:
Gender:F
Credentials:APRN, PLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:STONE HOUSE ASSOCIATES
Mailing Address - Street 2:27 RYE CIRCLE
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403
Mailing Address - Country:US
Mailing Address - Phone:802-654-7607
Mailing Address - Fax:802-654-9155
Practice Address - Street 1:STONE HOUSE ASSOCIATES
Practice Address - Street 2:27 RYE CIRCLE
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403
Practice Address - Country:US
Practice Address - Phone:802-654-7607
Practice Address - Fax:802-654-9155
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-14
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY406312163W00000X
VT101.0134268363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01420795Medicaid