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Individual

MS. MICHELLE DE LISIO

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
L.I.C.S.W., L.A.D.C.

Contact information

Practice address
25 GARFIELD ST, GREENFIELD, MA 01301-2512
(413) 772-8826
(413) 774-5946
Mailing address
25 GARFIELD ST, GREENFIELD, MA 01301-2512
(413) 772-8826
(413) 774-5946

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
314
MA
1041C0700X
Clinical Social Worker
1019513
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
101951
TUFTS HEALTH PLAN
MA
01
156061
MANAGED HEALTH NETWORK
MA
01
P07257
BLUE CROSS/BLUE SHIELD
MA
Enumeration date
09/15/2005
Last updated
09/11/2025
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