Edmondson, Lisa May

Edmondson, Lisa May is an sole proprietor health care provider with primary practice located at 106 N 1St Ave Suite A, Knightdale NC 27545-8093. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Edmondson, Lisa May can be contacted via phone (919) 210-4176.

Contact Information

Primary practice address
106 N 1St Ave Suite A Knightdale NC 27545-8093
Phone: (919) 210-4176
Fax: (877) 757-4728
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X C005608 North Carolina

Profile Details

NPI number 1265564645
LBN Legal business name Edmondson, Lisa May
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 12th, 2007
Last updated Jun 11th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265564645 NPPES
North Carolina MEDICAID 6106593

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