Individual provider · NPI-1

Elizabeth Bissell, LCSW

Social Worker, Clinical · San Carlos, CA

NPI number1205533957
StatusActive
Last updated in NPPESMay 21, 2024

Details

NPI
1205533957
Entity type
Individual (NPI-1)
Name
Elizabeth Bissell
Credential
LCSW
Sex
Female
Sole proprietor
Yes
Enumeration date
Feb 13, 2023
Certification date
May 21, 2024
Last updated
May 21, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, Clinical94933CAYes

Practice location

1350 Cherry St
San Carlos, CA 94070-3008

Phone 650-865-4300

Mailing address

656 Cedar St Apt C
San Carlos, CA 94070-8420

Phone 917-502-2816

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