Healthcare Provider Details

I. General information

NPI: 1447540232
Provider Name (Legal Business Name): LISA RENEE BATTLES LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LISA RENEE NOBLES

II. Dates (important events)

Enumeration Date: 04/13/2011
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15544 PACKAN DR
CLINTON TOWNSHIP MI
48038-4124
US

IV. Provider business mailing address

15544 PACKAN DR
CLINTON TOWNSHIP MI
48038-4124
US

V. Phone/Fax

Practice location:
  • Phone: 248-225-5508
  • Fax:
Mailing address:
  • Phone: 248-225-5508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL1765001
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: