Basic Information
Provider Information
NPI: 1609216555
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HARENSKI
FirstName: LISA
MiddleName: A
NamePrefix: MRS.
NameSuffix:  
Credential: LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 100 NEW SALEM RD STE 116
Address2:  
City: UNIONTOWN
State: PA
PostalCode: 154018936
CountryCode: US
TelephoneNumber: 7244370729
FaxNumber:  
Practice Location
Address1: 100 NEW SALEM RD STE 116
Address2:  
City: UNIONTOWN
State: PA
PostalCode: 154018936
CountryCode: US
TelephoneNumber: 7244370729
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/25/2013
LastUpdateDate: 09/28/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700XCW020125PAY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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