Provider Demographics
NPI:1760089593
Name:PERSON, LAKESHIA (MSW)
Entity Type:Individual
Prefix:MS
First Name:LAKESHIA
Middle Name:
Last Name:PERSON
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 1:4720 KENNEDY AVE
Mailing Address - Street 2:
Mailing Address - City:EAST CHICAGO
Mailing Address - State:IN
Mailing Address - Zip Code:46312-3505
Mailing Address - Country:US
Mailing Address - Phone:219-682-5404
Mailing Address - Fax:
Practice Address - Street 1:4720 KENNEDY AVE
Practice Address - Street 2:
Practice Address - City:EAST CHICAGO
Practice Address - State:IN
Practice Address - Zip Code:46312-3505
Practice Address - Country:US
Practice Address - Phone:219-682-5404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-05
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker