| Lisa Cannon Counseling, Llc | |
|
100 Saw Mill Rd Ste 3200 Lafayette IN 47905-5597 | |
| (765) 267-8534 | |
| (765) 374-0866 |
| Full Name | Lisa Cannon Counseling, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 100 Saw Mill Rd Ste 3200, Lafayette, Indiana |
| Authorized Official Name and Position | Lisa Cannon (SOLE MEMBER) |
| Authorized Official Contact | 7652678534 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa Cannon Counseling, Llc 100 Saw Mill Rd Ste 3200 Lafayette IN 47905-5597 Ph: (765) 267-8534 | Lisa Cannon Counseling, Llc 100 Saw Mill Rd Ste 3200 Lafayette IN 47905-5597 Ph: (765) 267-8534 |
| NPI Number | 1508479874 |
|---|---|
| Provider Enumeration Date | 08/26/2020 |
| Last Update Date | 11/29/2023 |
| Certification Date | 11/29/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508479874 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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