Provider Demographics
NPI:1992031017
Name:CLINE, LIZELLE ANNE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LIZELLE
Middle Name:ANNE
Last Name:CLINE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:913 KEY ROUTE BLVD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:CA
Mailing Address - Zip Code:94706-2121
Mailing Address - Country:US
Mailing Address - Phone:510-527-9260
Mailing Address - Fax:
Practice Address - Street 1:913 KEY ROUTE BLVD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:CA
Practice Address - Zip Code:94706-2121
Practice Address - Country:US
Practice Address - Phone:510-527-9260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-23
Last Update Date:2009-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA248081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical