Provider Demographics
NPI:1881486496
Name:BARNETT, LISA MARCELLA
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:MARCELLA
Last Name:BARNETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 BELMONT RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14612-4216
Mailing Address - Country:US
Mailing Address - Phone:585-313-9623
Mailing Address - Fax:585-313-9623
Practice Address - Street 1:1850 BUFFALO RD STE 200
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14624-1550
Practice Address - Country:US
Practice Address - Phone:585-420-7402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY905832141103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool