Doctor Name: | MRS. LISA HAUTER |
NPI Number: | 1417023870 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW CSADF |
License Number: | |
Business Practice Address: | 320 South Locust Street Carlinville, IL - 62626 |
Business Phone Number: | 2178543166 |
Business Fax Number: | 2178549729 |
Mailing Address: | 320 South Locust Street, CARLINVILLE |
State: | IL |
Postal Code: | 62626 |
Phone Number: | 2178543166 |
Fax Number: | 2178549729 |
NPI Enumeration Date: | 11/28/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |