Provider Demographics
NPI:1275145476
Name:STRODE, LISA MARIE (BSW)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:MARIE
Last Name:STRODE
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1038 COLUMBIA ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:KY
Mailing Address - Zip Code:41071-1484
Mailing Address - Country:US
Mailing Address - Phone:513-903-2548
Mailing Address - Fax:
Practice Address - Street 1:1974 WALTON NICHOLSON PIKE
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:KY
Practice Address - Zip Code:41051-7906
Practice Address - Country:US
Practice Address - Phone:513-903-2548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-19
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)