Provider Demographics
NPI:1407109952
Name:PLEASANTS, LISA RENN (LCSW)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:RENN
Last Name:PLEASANTS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 E. BESSEMER ST.
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401
Mailing Address - Country:US
Mailing Address - Phone:336-379-7144
Mailing Address - Fax:336-899-1511
Practice Address - Street 1:213 E. BESSSEMER ST.
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401
Practice Address - Country:US
Practice Address - Phone:336-379-7144
Practice Address - Fax:336-899-1511
Is Sole Proprietor?:No
Enumeration Date:2012-10-22
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0074081041C0700X
NC5823957371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical