Healthcare Provider Details

I. General information

NPI: 1336894690
Provider Name (Legal Business Name): CARLISLE ELIZABETH DUKES LUND LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2022
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1826 VETERANS BLVD
DUBLIN GA
31021-3620
US

IV. Provider business mailing address

1826 VETERANS BLVD
DUBLIN GA
31021-3631
US

V. Phone/Fax

Practice location:
  • Phone: 651-308-8383
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW009576
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: