Provider Demographics
NPI:1326538109
Name:ELIZABETH LANSING MSW PLLC
Entity Type:Organization
Organization Name:ELIZABETH LANSING MSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:LANSING
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:919-260-7665
Mailing Address - Street 1:310 E MAIN ST STE 330
Mailing Address - Street 2:
Mailing Address - City:CARRBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27510-2271
Mailing Address - Country:US
Mailing Address - Phone:919-260-7665
Mailing Address - Fax:919-942-3722
Practice Address - Street 1:310 E MAIN ST STE 330
Practice Address - Street 2:
Practice Address - City:CARRBORO
Practice Address - State:NC
Practice Address - Zip Code:27510
Practice Address - Country:US
Practice Address - Phone:919-260-7665
Practice Address - Fax:919-942-3722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-16
Last Update Date:2021-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0102241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1477870608Medicaid