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General NPI Number Information
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NPI Number | 1316243520
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Entity Type | Organization
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Legal Business Name | LISA FOLEY, LCSW
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Dates
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Enumeration Date | 02/04/2011
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Last Update Date | 02/07/2011
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Provider Practice Location Address
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Address Line | 615 SIERRA ROSE DR SUITE 4
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City | RENO
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State | NV
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Zip | 89511-2365
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Country | US
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Telephone | 775-826-1002
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Fax |
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Provider Business Mailing Address
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Address Line | 2100 DANT BLVD
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City | RENO
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State | NV
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Zip | 89509
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Country | US
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Telephone | 775-772-3463
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LISA K FOLEY
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Credential | LCSW
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Telephone | 775-772-3463
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 5072-C
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License Number State | NV
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