Provider Demographics
NPI:1710416433
Name:CARTER, LISA HANNIGAN (MSW)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:HANNIGAN
Last Name:CARTER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 VILLAGE CT
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33896-5222
Mailing Address - Country:US
Mailing Address - Phone:305-989-3139
Mailing Address - Fax:
Practice Address - Street 1:232 VILLAGE CT
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33896-5222
Practice Address - Country:US
Practice Address - Phone:305-989-3139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor