MEDICARE: CARLA CASSADA LEMON M.S.W., L. C.S.W.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	3698	KY

General Provider Information

NPI Number	:	1730227364
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLA CASSADA LEMON M.S.W., L. C.S.W.

Provider Business Mailing Address
First Line	:	80 CODELL DR
Second Line	:	STE 220
City	:	LEXINGTON
State	:	KY
Zip	:	40509-1178
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	80 CODELL DR
Second Line	:	STE 220
City	:	LEXINGTON
State	:	KY
Zip	:	40509-1178
Country	:	US
Telephone Number	:	859-279-4462
Fax Number	:	859-203-0795

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2007
Last Update Date	:	04/13/2020

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