Provider Demographics
NPI:1871782375
Name:LISA ORANSOFF PHD LLC
Entity type:Organization
Organization Name:LISA ORANSOFF PHD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:ORANSOFF
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:860-306-4341
Mailing Address - Street 1:18 DOG LN
Mailing Address - Street 2:SUITE C
Mailing Address - City:STORRS MANSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06268-2225
Mailing Address - Country:US
Mailing Address - Phone:860-306-4341
Mailing Address - Fax:
Practice Address - Street 1:18 DOG LN
Practice Address - Street 2:SUITE C
Practice Address - City:STORRS MANSFIELD
Practice Address - State:CT
Practice Address - Zip Code:06268-2225
Practice Address - Country:US
Practice Address - Phone:860-306-4341
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-19
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1505103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty