Provider Demographics
NPI:1184941825
Name:JAMIESON, LISA N (LCSW)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:N
Last Name:JAMIESON
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 1:1701 SCENIC WAY
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-4975
Mailing Address - Country:US
Mailing Address - Phone:907-244-9474
Mailing Address - Fax:907-278-7221
Practice Address - Street 1:1701 SCENIC WAY
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-4975
Practice Address - Country:US
Practice Address - Phone:907-244-9474
Practice Address - Fax:907-278-7221
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-20
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK6171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical