Healthcare Provider Details

I. General information

NPI: 1811910045
Provider Name (Legal Business Name): KERRY D LEHMAN MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 04/28/2023
Certification Date: 04/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 ENTERPRISE DR
WARSAW IN
46580-1204
US

IV. Provider business mailing address

105 ENTERPRISE DR
WARSAW IN
46580-1204
US

V. Phone/Fax

Practice location:
  • Phone: 574-268-0448
  • Fax:
Mailing address:
  • Phone: 574-268-0448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34009825A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2003032217
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: