Lisa Jolene Brown Tabor
Individual provider Active NPI Social Worker · Clinton, IN
NPI 1851132971 · NPPES record last updated Jun 3, 2024
Key facts
- NPI
- 1851132971
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- Practice address
- 777 S Main St Ste 100
Clinton, IN 47842-2493 - Phone
- (765) 828-1003
- NPI assigned
- Jun 3, 2024
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Yes |
Addresses
Primary practice location
777 S Main St Ste 100
Clinton, IN 47842-2493
Mailing address
777 S Main St Ste 100
Clinton, IN 47842-2493
Phone (765) 828-1003
Other providers in Clinton, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 3, 2024. 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.