Provider Demographics
NPI:1154870467
Name:ZAMBER, LISA MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:MARIE
Last Name:ZAMBER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 BEACH RD
Mailing Address - Street 2:
Mailing Address - City:RIVERHEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11901-5819
Mailing Address - Country:US
Mailing Address - Phone:808-589-9596
Mailing Address - Fax:
Practice Address - Street 1:790 PARK AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-4516
Practice Address - Country:US
Practice Address - Phone:631-427-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-27
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY092718-01101YM0800X
NY097254-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health