Liza Detenber, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

122397 Issued in MA

Practice address

867 Boylston St FL 5
Boston, MA 02116-2774

Phone

(781) 630-5774

Fax

(781) 236-8615

NPI assigned

Jul 29, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Liza Detenber, PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Worcester, MA
  • NPI 1811607443
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1469750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1992258578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "867 BOYLSTON ST FL 5",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021162774",
            "telephone_number": "781-630-5774",
            "fax_number": "781-236-8615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "867 BOYLSTON ST FL 5",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021162774",
            "telephone_number": "781-630-5774",
            "fax_number": "781-236-8615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETENBER",
        "first_name": "LIZA",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-29",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "122397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas R Destefino
• Nindra Destine, PA-C
• Erline Destra, NP
• Suzette Desty, MD
• Bharti Balhara Deswal, MD
• Lauren Louise Detmer, PT, DPT
• Annette Detrolio, RDN, LDN
• Carl E Dettman, M.D.
• Nicole Dettmann, PA
• Thomas Andrew Deuel, M.D., PH.D.

• All providers in Boston, MA
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.