Healthcare Provider Details

I. General information

NPI: 1528237047
Provider Name (Legal Business Name): LISA C HUFF LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2008
Last Update Date: 08/16/2021
Certification Date: 08/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 CENTRAL AVE STE 2
ASHLAND KY
41101-7575
US

IV. Provider business mailing address

2201 LEXINGTON AVE
ASHLAND KY
41101-2843
US

V. Phone/Fax

Practice location:
  • Phone: 606-408-1542
  • Fax: 606-408-6866
Mailing address:
  • Phone: 606-327-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberKY-972
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: