Provider Demographics
NPI:1720639909
Name:BROWN, LISA BETH (PHD, LCSW, MED)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:BETH
Last Name:BROWN
Suffix:
Gender:
Credentials:PHD, LCSW, MED
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:HOCHBERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, LCSW, MED
Mailing Address - Street 1:1289 LEXINGTON AVE APT 16A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-2230
Mailing Address - Country:US
Mailing Address - Phone:516-639-2072
Mailing Address - Fax:
Practice Address - Street 1:60 PLAZA ST E
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-5025
Practice Address - Country:US
Practice Address - Phone:516-639-2072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-27
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0943821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty