Provider Demographics
NPI:1124349972
Name:WOOD, LISA KATHERINE (LCSW)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:KATHERINE
Last Name:WOOD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:LISA
Other - Middle Name:KATHERINE
Other - Last Name:NWOKONKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2 WATERVIEW RD APT E1
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-6356
Mailing Address - Country:US
Mailing Address - Phone:484-753-5547
Mailing Address - Fax:
Practice Address - Street 1:80 W WELSH POOL RD STE 103S
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-1233
Practice Address - Country:US
Practice Address - Phone:484-753-5547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-16
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0141571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical