MEDICARE: LISA FRANKLIN LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	34007077A	IN

General Provider Information

NPI Number	:	1033529243
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA FRANKLIN LCSW

Provider Business Mailing Address
First Line	:	48 N. EMERSON AVE., SUITE 650
Second Line	:
City	:	GREENWOOD
State	:	IN
Zip	:	46143-1464
Country	:	US
Telephone Number	:	317-496-0456
Fax Number	:

Provider Business Practice Location Address
First Line	:	48 N. EMERSON AVE., SUITE 650
Second Line	:
City	:	GREENWOOD
State	:	IN
Zip	:	46143-1464
Country	:	US
Telephone Number	:	317-496-0456
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/28/2014
Last Update Date	:	10/11/2022

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