Kelley, Lisa Danielle

Kelley, Lisa Danielle is an individual health care provider with primary practice located at 5400 Laurel Springs Pkwy Suite 1101, Suwanee GA 30024-6056. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Kelley, Lisa Danielle can be contacted via phone (678) 908-5543.

Contact Information

Primary practice address
5400 Laurel Springs Pkwy Suite 1101 Suwanee GA 30024-6056
Phone: (678) 908-5543
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 003314 Georgia

Profile Details

NPI number 1750454328
LBN Legal business name Kelley, Lisa Danielle
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 15th, 2006
Last updated Apr 29th, 2008 - about 16 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 1750454328 NPPES
Georgia MEDICAID 220143218A

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