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NPI Code Detail

MEDICARE: MS. LISA KILCREASE LCSW

MEDICARE: MS. LISA KILCREASE 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
11041C0700XClinical Social Worker2392-CAR

General Provider Information

NPI Number : 1053439836
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LISA KILCREASE LCSW
Provider Business Mailing Address
First Line : 136 DREAMS END
Second Line :
City : MONTICELLO
State : AR
Zip : 71655-9662
Country : US
Telephone Number : 870-367-1182
Fax Number :
Provider Business Practice Location Address
First Line : 1371 HIGHWAY 278 W
Second Line :
City : MONTICELLO
State : AR
Zip : 71655-9663
Country : US
Telephone Number : 870-367-2141
Fax Number : 870-367-2103
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2007
Last Update Date : 10/07/2010

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Directions to “ MS. LISA KILCREASE LCSW” Practice Location

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