Healthcare Provider Details

I. General information

NPI: 1285935197
Provider Name (Legal Business Name): LISA A BARRESI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2010
Last Update Date: 11/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NUNN DRIVE UNIVERSITY CENTER #440
HIGHLAND HEIGHTS KY
41099
US

IV. Provider business mailing address

PO BOX 671205
DALLAS TX
75267-1205
US

V. Phone/Fax

Practice location:
  • Phone: 859-572-5650
  • Fax: 859-572-5615
Mailing address:
  • Phone: 866-890-6390
  • Fax: 469-735-4640

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: