Provider Demographics
NPI:1467996371
Name:ALMON, LISA B (LCSW)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:B
Last Name:ALMON
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 1:7520 E 88TH PL
Mailing Address - Street 2:SUITE 101
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-1253
Mailing Address - Country:US
Mailing Address - Phone:317-760-8863
Mailing Address - Fax:855-450-1177
Practice Address - Street 1:7520 E 88TH PL
Practice Address - Street 2:SUITE 101
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-1253
Practice Address - Country:US
Practice Address - Phone:317-760-8863
Practice Address - Fax:855-450-1177
Is Sole Proprietor?:No
Enumeration Date:2016-12-12
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34000006A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ININ1582Medicare Oscar/Certification