Individual
LISA IBEKWE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1091 OVERLOOK PKWY, MACON, GA 31210
(470) 242-6140
Mailing address
3001 BRASS DR, AUSTELL, GA 30106-1043
(678) 717-9119
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW006976
GA
1041C0700X
Clinical Social Worker
MSW007359
GA
Other
Enumeration date
10/18/2017
Last updated
01/04/2020
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