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NPI Code Detail

MEDICARE: LISA WILKINSON LCSW

MEDICARE: LISA WILKINSON 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
1104100000XSocial WorkerIC-1042NV
2104100000XSocial Worker4027-SNV
31041C0700XClinical Social Worker8437-CNV

General Provider Information

NPI Number : 1295156487
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA WILKINSON LCSW
Provider Business Mailing Address
First Line : 1515 7TH ST
Second Line :
City : ELKO
State : NV
Zip : 89801-2859
Country : US
Telephone Number : 775-299-3738
Fax Number : 775-738-3052
Provider Business Practice Location Address
First Line : 1515 7TH ST
Second Line :
City : ELKO
State : NV
Zip : 89801-2859
Country : US
Telephone Number : 775-299-3738
Fax Number : 775-738-3052
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2013
Last Update Date : 08/09/2019

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Directions to “ LISA WILKINSON LCSW” Practice Location

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