Lakeisha Johnson-Elmore, LCSW
Individual provider Active NPI Clinical Social Worker · Horn Lake, MS
NPI 1487051678 · NPPES record last updated May 20, 2021
Key facts
- NPI
- 1487051678
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- LSW0000007453 (TN)
- Practice address
- 5565 Kings Retreat Dr E
Horn Lake, MS 38637-7010 - Phone
- (662) 897-8940
- NPI assigned
- Dec 3, 2014
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7551-C | AR | MD | Clinical Social Worker |
| C8311 | MS | MD | Clinical Social Worker |
| LSW0000007453 | TN | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | |||
| Clinical Social Worker | 1041C0700X | 7551-C | AR | |
| Clinical Social Worker | 1041C0700X | C8311 | MS | |
| Clinical Social Worker | 1041C0700X | LSW0000007453 | TN | Yes |
Addresses
Primary practice location
5565 Kings Retreat Dr E
Horn Lake, MS 38637-7010
Mailing address
5565 Kings Retreat Dr E
Horn Lake, MS 38637-7010
Phone (662) 897-8940
Other practice location 1
2707 Browns Ln
Jonesboro, AR 72401-7213
Phone (870) 972-4939
Other providers in Horn Lake, MS
- Horn Lake Family Practice
- Horn Lake Family Practice Inc
- Preston E Huggins
- Innovative Therapy Services LLC
- Helen Joe
- Darnell Johnson
- Syrenia Johnson
- Felecia S Flowers Jones
- Steven Robert Jones
- Luther Boyd Koon
All providers in Horn Lake, MS · Clinical Social Worker in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 20, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.