Provider Demographics
NPI:1033152731
Name:HARCOURT, LISBETH WARNER (LMSW)
Entity Type:Individual
Prefix:
First Name:LISBETH
Middle Name:WARNER
Last Name:HARCOURT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 WHITLOCK ST
Mailing Address - Street 2:
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176-9601
Mailing Address - Country:US
Mailing Address - Phone:734-355-6815
Mailing Address - Fax:
Practice Address - Street 1:205 N EAST AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-1753
Practice Address - Country:US
Practice Address - Phone:517-789-5971
Practice Address - Fax:517-789-5918
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801083008104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker