Individual
MS. LISA BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCADC
Contact information
Practice address
3000 NJ-10 WEST, MORRIS PLAINS, NJ 07950
(973) 944-1222
Mailing address
162 PARK AVE APT A3, EAST ORANGE, NJ 07017-5223
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37LC00339300
NJ
Other
Enumeration date
10/13/2022
Last updated
10/13/2022
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