Provider Demographics
NPI:1588275515
Name:LISA BARGELLINI THERAPY
Entity type:Organization
Organization Name:LISA BARGELLINI THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:BARGELLINI
Authorized Official - Last Name:LUSBY
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:914-649-3071
Mailing Address - Street 1:297 KNOLLWOOD RD STE 304
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10607-1849
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:297 KNOLLWOOD RD STE 304
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10607-1849
Practice Address - Country:US
Practice Address - Phone:914-649-3071
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-13
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty