Provider Demographics
NPI:1215289368
Name:ROBIDEAU, LISA A (MA, LMHC, LADC 1)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:A
Last Name:ROBIDEAU
Suffix:
Gender:F
Credentials:MA, LMHC, LADC 1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 UNION AVE
Mailing Address - Street 2:SUITE 11
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-8287
Mailing Address - Country:US
Mailing Address - Phone:508-620-2992
Mailing Address - Fax:508-620-2993
Practice Address - Street 1:24 UNION AVE
Practice Address - Street 2:SUITE 11
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-8287
Practice Address - Country:US
Practice Address - Phone:508-620-2992
Practice Address - Fax:508-620-2993
Is Sole Proprietor?:No
Enumeration Date:2012-10-12
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)