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NPI Code Detail

MEDICARE: LISA HAWK M.S.W., L.I.S.W.

MEDICARE: LISA HAWK M.S.W., L.I.S.W.
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 Worker02241IA

General Provider Information

NPI Number : 1760575351
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA HAWK M.S.W., L.I.S.W.
Provider Business Mailing Address
First Line : 3033 N CENTRAL AVE # 550
Second Line :
City : PHOENIX
State : AZ
Zip : 85012-2809
Country : US
Telephone Number : 602-230-7373
Fax Number :
Provider Business Practice Location Address
First Line : 3033 N CENTRAL AVE STE 700
Second Line :
City : PHOENIX
State : AZ
Zip : 85012-2806
Country : US
Telephone Number : 602-230-7373
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2006
Last Update Date : 06/26/2024

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