Jackson-Eldridge, Lisa

Jackson-Eldridge, Lisa is an individual health care provider with primary practice located at 501 S Burma Ave , Gillette WY 82716-3426. She recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as her primary health care specialty. Jackson-Eldridge, Lisa can be contacted via phone (307) 688-5029.

Contact Information

Primary practice address
501 S Burma Ave Gillette WY 82716-3426
Phone: (307) 688-5029
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X

Profile Details

NPI number 1255949525
LBN Legal business name Jackson-Eldridge, Lisa
Credentials MSW
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 22nd, 2020
Last updated Jul 22nd, 2020 - about 6 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 1255949525 NPPES
Wyoming MEDICAID 830234097

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