Provider Demographics
NPI:1447973649
Name:NETHERY, LISABETH SEARS
Entity type:Individual
Prefix:
First Name:LISABETH
Middle Name:SEARS
Last Name:NETHERY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LIBBY
Other - Middle Name:
Other - Last Name:SEARS NETHERY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CSW
Mailing Address - Street 1:883 ABINGDON LN
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40065-6310
Mailing Address - Country:US
Mailing Address - Phone:270-304-7423
Mailing Address - Fax:
Practice Address - Street 1:106 BELINDA BLVD
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422-3217
Practice Address - Country:US
Practice Address - Phone:859-209-2320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-22
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY257068104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker