Provider Demographics
NPI:1679731376
Name:SEBASTIANI, LISA MARIE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:MARIE
Last Name:SEBASTIANI
Suffix:
Gender:F
Credentials:LCSW
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Mailing Address - Street 1:11279 PERRY HWY FL 4
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-9381
Mailing Address - Country:US
Mailing Address - Phone:724-934-4111
Mailing Address - Fax:724-934-4135
Practice Address - Street 1:11279 PERRY HIGHWAY FOURTH FLOOR SUITE
Practice Address - Street 2:SUITE 400
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-8769
Practice Address - Country:US
Practice Address - Phone:724-934-4111
Practice Address - Fax:724-934-4135
Is Sole Proprietor?:No
Enumeration Date:2008-05-29
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0159911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical