Healthcare Provider Details

I. General information

NPI: 1467996371
Provider Name (Legal Business Name): LISA B ALMON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2016
Last Update Date: 12/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7520 E 88TH PL SUITE 101
INDIANAPOLIS IN
46256-1253
US

IV. Provider business mailing address

7520 E 88TH PL SUITE 101
INDIANAPOLIS IN
46256-1253
US

V. Phone/Fax

Practice location:
  • Phone: 317-760-8863
  • Fax: 855-450-1177
Mailing address:
  • Phone: 317-760-8863
  • Fax: 855-450-1177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34000006A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: