Provider Demographics
NPI:1598788747
Name:CREEF, LISA BUTLER (LCSW, PC)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:BUTLER
Last Name:CREEF
Suffix:
Gender:F
Credentials:LCSW, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 188
Mailing Address - Street 2:
Mailing Address - City:SOUTH MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:27976-0188
Mailing Address - Country:US
Mailing Address - Phone:252-335-5346
Mailing Address - Fax:252-335-5365
Practice Address - Street 1:1241 B. NORTH ROAD ST.
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-3335
Practice Address - Country:US
Practice Address - Phone:252-335-5346
Practice Address - Fax:252-335-5365
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0061381041C0700X
VA09040014971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6007190Medicaid