Provider Demographics
NPI:1902579907
Name:PEIRCE, LISA (BS)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:PEIRCE
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:YARMOUTH PORT
Mailing Address - State:MA
Mailing Address - Zip Code:02675-1770
Mailing Address - Country:US
Mailing Address - Phone:508-771-3156
Mailing Address - Fax:
Practice Address - Street 1:221 WILLOW ST
Practice Address - Street 2:
Practice Address - City:YARMOUTH PORT
Practice Address - State:MA
Practice Address - Zip Code:02675-1770
Practice Address - Country:US
Practice Address - Phone:508-771-3156
Practice Address - Fax:508-771-3287
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-27
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health