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General NPI Number Information
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NPI Number | 1356208649
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Entity Type | Organization
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Legal Business Name | LISA CRISWELL, LICENSED CLINICAL SOCIAL WORKER
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Dates
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Enumeration Date | 01/07/2026
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Last Update Date | 01/14/2026
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Provider Practice Location Address
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Address Line | 4946 E YALE AVE STE 103
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City | FRESNO
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State | CA
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Zip | 93727-1571
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Country | US
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Telephone | 559-681-8707
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Fax |
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Provider Business Mailing Address
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Address Line | 6764 N RAFAEL AVE
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City | FRESNO
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State | CA
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Zip | 93711-0828
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Country | US
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Telephone | 559-681-8707
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | LISA CRISWELL
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Credential | LCSW, PHD
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Telephone | 559-681-8707
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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 |
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License Number State |
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