Provider Demographics
NPI:1013281880
Name:ANTHONY, LISA RENE (LCSW)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:RENE
Last Name:ANTHONY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:ANTHONY
Other - Last Name:WEEKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1 HOSPITAL RD
Mailing Address - Street 2:CALLER BOX C-268
Mailing Address - City:CHEROKEE
Mailing Address - State:NC
Mailing Address - Zip Code:28719-9253
Mailing Address - Country:US
Mailing Address - Phone:828-497-9163
Mailing Address - Fax:828-497-1723
Practice Address - Street 1:375 SEQUOYAH TRL
Practice Address - Street 2:
Practice Address - City:CHEROKEE
Practice Address - State:NC
Practice Address - Zip Code:28719
Practice Address - Country:US
Practice Address - Phone:828-497-6892
Practice Address - Fax:828-497-6977
Is Sole Proprietor?:No
Enumeration Date:2012-02-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0083351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1013281880Medicaid
NC1829TOtherBCBS
Q45277AMedicare PIN