Provider Demographics
NPI:1558945873
Name:ANDERSON, LISA LAFAYE (LCSW)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:LAFAYE
Last Name:ANDERSON
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 1:2021 RICHARD JONES RD STE 350B
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2871
Mailing Address - Country:US
Mailing Address - Phone:615-589-3136
Mailing Address - Fax:
Practice Address - Street 1:2021 RICHARD JONES RD STE 350B
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-2871
Practice Address - Country:US
Practice Address - Phone:615-270-8375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-12
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN75881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN7588OtherLCSW