Provider Demographics
NPI:1548462054
Name:LIGHTFOOT, LESA MCANALLY (LCSW)
Entity type:Individual
Prefix:MRS
First Name:LESA
Middle Name:MCANALLY
Last Name:LIGHTFOOT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:LESA
Other - Middle Name:M
Other - Last Name:LIGHTFOOT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:201 MCKENZIE LN
Mailing Address - Street 2:
Mailing Address - City:SUMMERTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38483-4104
Mailing Address - Country:US
Mailing Address - Phone:931-964-4037
Mailing Address - Fax:
Practice Address - Street 1:24 PUBLIC SQ
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:TN
Practice Address - Zip Code:38464-3350
Practice Address - Country:US
Practice Address - Phone:931-242-6691
Practice Address - Fax:931-762-8820
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW00000045271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical