Provider Demographics
NPI:1447659511
Name:DELAPLACE, LISA A (MSW,LCSW)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:A
Last Name:DELAPLACE
Suffix:
Gender:F
Credentials:MSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5750 GENESIS CT STE 135
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-4229
Mailing Address - Country:US
Mailing Address - Phone:425-686-5631
Mailing Address - Fax:
Practice Address - Street 1:5750 GENESIS CT STE 135
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-4229
Practice Address - Country:US
Practice Address - Phone:425-686-5631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-14
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1072931041C0700X
WA607937821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA217035600Medicaid