Individual
CHARLOTTE LIVELY
Active
Individual
CHARLOTTE LIVELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW-S
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
SX61313303
WA
1041C0700X
Clinical Social Worker
0904014631
VA
1041C0700X
Clinical Social Worker
30918
MD
1041C0700X
Clinical Social Worker
Primary
I.2203481
OH
Other
Enumeration date
01/16/2019
Last updated
08/27/2026
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