MEDICARE: LISA LOCKHART

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	171M00000X	Case Manager/Care Coordinator	OH
2	253Z00000X	In Home Supportive Care Agency
3	104100000X	Social Worker

General Provider Information

NPI Number	:	1952067852
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA LOCKHART

Provider Business Mailing Address
First Line	:	11907 GRANGER RD
Second Line	:
City	:	GARFIELD HEIGHTS
State	:	OH
Zip	:	44125-2911
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11907 GRANGER RD
Second Line	:
City	:	GARFIELD HEIGHTS
State	:	OH
Zip	:	44125-2911
Country	:	US
Telephone Number	:	440-319-7008
Fax Number	:

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

Provider Enumeration Date	:	11/15/2021
Last Update Date	:	10/06/2025

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Directions to “ LISA LOCKHART ” Practice Location

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