Provider Demographics
NPI:1831661438
Name:NAFZIGER, LISA JO (MSW, LICSW, LCSW-PIP)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:JO
Last Name:NAFZIGER
Suffix:
Gender:F
Credentials:MSW, LICSW, LCSW-PIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 E 41ST ST STE 136
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-6049
Mailing Address - Country:US
Mailing Address - Phone:605-271-0603
Mailing Address - Fax:605-271-4720
Practice Address - Street 1:707 E 41ST ST STE 136
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-6049
Practice Address - Country:US
Practice Address - Phone:605-271-0603
Practice Address - Fax:605-271-4720
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-19
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD4803104100000X, 1041C0700X
SD50701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD1831661438Medicaid