Provider Demographics
NPI:1548512437
Name:LUSE, LISA (LICSW, LCSW-C)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:LUSE
Suffix:
Gender:F
Credentials:LICSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2912 RITTENHOUSE ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-1524
Mailing Address - Country:US
Mailing Address - Phone:202-365-0178
Mailing Address - Fax:
Practice Address - Street 1:6430 ROCKLEDGE DR
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1805
Practice Address - Country:US
Practice Address - Phone:202-607-2497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-03
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD177721041C0700X
DCLC500794981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical