Crain, Lisa K

Crain, Lisa K is an individual health care provider with primary practice located at 1600 Broad Ave , Gulfport MS 39501-3603. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Crain, Lisa K can be contacted via phone (228) 863-1132.

Contact Information

Primary practice address
1600 Broad Ave Gulfport MS 39501-3603
Phone: (228) 863-1132
Fax: (228) 865-1700
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X W3612 Mississippi
Behavioral Health & Social Service Providers / Professional 101YP2500X W3612 Mississippi

Profile Details

NPI number 1144254491
LBN Legal business name Crain, Lisa K
Credentials MED,LSW,CMHT
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144254491 NPPES
Mississippi MEDICAID 00018213

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