Individual
LISA A. WITHROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSSW, LCSW
Contact information
Practice address
415 MULBERRY ST, EVANSVILLE, IN 47713-1230
(812) 473-3144
(812) 422-7558
Mailing address
415 MULBERRY STREET, EVANSVILLE, IN 47713-1230
(812) 423-7791
(812) 422-7558
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
34003565A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000
ANTHEM
—
05
—
100240880
—
IN
Enumeration date
04/13/2007
Last updated
08/27/2020
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