Individual
MS. LISA BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASAC-2
Contact information
Practice address
20 CHURCH STREET, WHITE PLAINS, NY 10601
(914) 683-8050
(914) 683-8054
Mailing address
10 NORTHWIND RD, YONKERS, NY 10710-1730
(914) 707-2544
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
32421
NY
Other
Enumeration date
04/28/2022
Last updated
04/28/2022
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