Grossenbacher, Lisa

Grossenbacher, Lisa is an sole proprietor health care provider with primary practice located at 1603 E 19Th St Ste 105 , Edmond OK 73013-6563. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Grossenbacher, Lisa can be contacted via phone (405) 568-1950.

Contact Information

Primary practice address
1603 E 19Th St Ste 105 Edmond OK 73013-6563
Phone: (405) 568-1950
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X
Behavioral Health & Social Service Providers / Clinical 1041C0700X 4276 Oklahoma

Profile Details

NPI number 1013157510
LBN Legal business name Grossenbacher, Lisa
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 24th, 2009
Last updated Aug 7th, 2023 - about 3 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 1013157510 NPPES
Oklahoma MEDICAID 200362310A

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