Individual
LISA STAAB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LISW-CP
Contact information
Practice address
671 JAMESTOWN DR UNIT 102, MURRELLS INLET, SC 29576-7511
(316) 680-4794
(316) 680-4794
Mailing address
PO BOX 1492, MURRELLS INLET, SC 29576-1492
(316) 680-4794
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
09924360
CO
1041C0700X
Clinical Social Worker
11774
SC
1041C0700X
Clinical Social Worker
Primary
12048
WI
1041C0700X
Clinical Social Worker
6801117714
MI
Other
Enumeration date
08/06/2016
Last updated
01/21/2025
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