Provider Demographics
NPI:1760648265
Name:METCALF, LISA M (EDD, LCSW)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:M
Last Name:METCALF
Suffix:
Gender:F
Credentials:EDD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1521 STARR DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95993-2656
Mailing Address - Country:US
Mailing Address - Phone:530-591-3212
Mailing Address - Fax:
Practice Address - Street 1:1521 STARR DR
Practice Address - Street 2:SUITE B
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95993-2656
Practice Address - Country:US
Practice Address - Phone:530-591-3212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-04
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 201681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical