Organization
LISA ANTONICK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA ANTONICK LCSW,LCAS, CCS (CLINICAL DIRECTOR)
(518) 669-1798
Entity
Organization
Contact information
Practice address
105 LONGLEAF PL, CARY, NC 27518-8919
(518) 669-1798
Mailing address
105 LONGLEAF PL, CARY, NC 27518-8919
(518) 669-1798
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/20/2023
Last updated
04/22/2026
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