Most Relevant Information
Provider Data
| NPI Number: | 1003011321 |
| Provider Name: | LISA DIANE BARKSTALL LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 149.005051 |
Most Important Dates
| Enumeration Date: | 06/18/2007 |
| Last Updated: | 04/08/2014 |
Provider Practice Location
1801 FOX DR
CHAMPAIGN
IL
618207236
Practice Location Phone/Fax
| Phone: | 2173988080 |
| Fax: |
Provider Mailing Location
704 ARLINGTON CT
CHAMPAIGN
IL
618205002
Provider Mailing Phone/Fax
| Phone: | 7737033583 |
| Fax: |