Provider Demographics
NPI:1770822157
Name:CARMAN, LISA
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:CARMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1485 W WARM SPRINGS RD STE 109
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-7632
Mailing Address - Country:US
Mailing Address - Phone:702-486-7511
Mailing Address - Fax:
Practice Address - Street 1:1485 W WARM SPRINGS RD STE 109
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-7632
Practice Address - Country:US
Practice Address - Phone:702-486-7511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-05
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5127-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical