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Individual

LISA MICHELLE PYENSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
42 SUMMER ST, PITTSFIELD, MA 01201-4624
(413) 442-0402
(508) 753-5051
Mailing address
450 MAIN STREET, SUITE 450, WORCESTER, MA 01605
(508) 752-2590
(508) 753-5051

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
101YM0800X
Mental Health Counselor

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1306461
MA
05
1308785
MA
01
22220002001
BLUE CROSS BLUE SHEILD
MA
01
M18684
BLUE CROSS OF MASS
MA
Enumeration date
10/16/2012
Last updated
10/16/2012
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