Lisa K Broussard, LCSW008306
Lisa K Broussard, LCSW008306 is a Clinical Social Worker in Jasper, Georgia. Qualified in 2019, 7 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Georgia.
- Years since qualifying
- 7
- Licensed in
- GA
- In the registry since
- 2022
- Specialties on file
- 2
Practice location Address checks out
27 S Main StJasper, GA 30143-1600
Phone: (678) 230-5164
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Clinical Social Worker (primary) | Taxonomy 1041C0700X · Licence CSW008306 (GA) |
|---|---|
| Mental Health Counselor | Taxonomy 101YM0800X · Licence LMSW009255 (GA) |
Record details
| NPI number | 1952045338 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Credentials | LCSW008306 |
| Sole proprietor | Yes |
| NPI enumerated | April 22, 2022 |
| Last updated in NPPES | July 3, 2023 |
| Certification date | July 3, 2023 |
Medicare enrollment
| Medicare specialty | CLINICAL SOCIAL WORKER |
|---|---|
| Medical school | OTHER |
| Graduated | 2019 (7 years in practice) |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
Other providers in Jasper
-
Collaborations for Resiliency in Children, Inc
2404 Refuge Rd, Jasper, GA 30143-4946 · (706) 692-7209
-
Michelle Grunkemeyer
2404 Refuge Rd, Jasper, GA 30143-4946 · (706) 692-7209
-
Stacy Ann Harris
630 E Church St, Jasper, GA 30143-1312 · (678) 779-4223
-
Victoria Tigner Reaves, LPC
2404 Refuge Rd, Jasper, GA 30143-4946 · (706) 692-7209