Provider Demographics
NPI:1972266815
Name:LAVOI, ALISA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ALISA
Middle Name:
Last Name:LAVOI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:ALISA
Other - Middle Name:
Other - Last Name:MERINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:4458 E FACETO ST
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-5720
Mailing Address - Country:US
Mailing Address - Phone:775-315-5020
Mailing Address - Fax:
Practice Address - Street 1:2484 N STOKESBERRY PL STE 150
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83646-6084
Practice Address - Country:US
Practice Address - Phone:775-315-5020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-18
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID88617101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID00010006259OtherREGENCE BLUE SHIELD
ID88567OtherBLUE CROSS
ID002269500Medicaid