Provider Demographics
NPI:1992566863
Name:CULP, LISA MARIE (LMSW)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:MARIE
Last Name:CULP
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:737 N KALAMAZOO AVE
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MI
Mailing Address - Zip Code:49068-1072
Mailing Address - Country:US
Mailing Address - Phone:269-275-0907
Mailing Address - Fax:
Practice Address - Street 1:391 S SHORE DR STE 214
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49014-5446
Practice Address - Country:US
Practice Address - Phone:269-964-0153
Practice Address - Fax:855-877-5812
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-18
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011164341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical