Organization
LISA CANNON COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA CANNON LCSW (SOLE MEMBER)
(765) 267-8534
Entity
Organization
Contact information
Practice address
100 SAW MILL RD STE 3200, LAFAYETTE, IN 47905-5597
(765) 267-8534
(765) 374-0866
Mailing address
100 SAW MILL RD STE 3200, LAFAYETTE, IN 47905-5597
(765) 267-8534
(765) 374-0866
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
08/26/2020
Last updated
11/29/2023
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