Healthcare Provider Details

I. General information

NPI: 1598498826
Provider Name (Legal Business Name): LISA DAWN HUTCHINSON BSW, MSM-HR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2022
Last Update Date: 07/05/2022
Certification Date: 07/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1006 HUMMINGBIRD LN
COLUMBUS IN
47203-1309
US

IV. Provider business mailing address

1006 HUMMINGBIRD LN
COLUMBUS IN
47203-1309
US

V. Phone/Fax

Practice location:
  • Phone: 812-350-5266
  • Fax: 812-418-8000
Mailing address:
  • Phone: 812-350-5266
  • Fax: 812-418-8000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: