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Organization
LISA J. KEITH, LCSW, PLLC
Active
Organization
LISA J. KEITH, LCSW, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA JOHNSON KEITH LCSW (MANAGER/PARTNER)
(919) 922-2055
Entity
Organization
Contact information
Practice address
112 ADLER LN, GOLDSBORO, NC 27530-5513
(919) 580-0790
(919) 735-9238
Mailing address
112 ADLER LN, GOLDSBORO, NC 27530-5513
(919) 580-0790
(919) 735-9238
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C002693
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
142JF
BCBS OF NC
NC
01
—
190281
MEDCOST
NC
05
—
6005936
—
NC
01
—
785920000
MAGELLAN
NC
Enumeration date
09/16/2006
Last updated
01/16/2009
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