Individual provider Active NPI

Lisa Katherine Degraff, LMSW

  • Clinical Social Worker
  • Austin, TX
National Provider Identifier
1003063678
Registry record updated Jun 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
60328 Issued in TX
Practice address
4425 S Mo Pac Expy Ste 602
Austin, TX 78735-6757
Phone
(512) 893-7265
NPI assigned
Aug 26, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 7236 KS
Clinical Social Worker 1041C0700X 7236 KS
Clinical Social Worker 1041C0700X 60328 TX Primary

Addresses

Primary practice location

4425 S Mo Pac Expy Ste 602
Austin, TX 78735-6757

Mailing address

4425 S Mo Pac Expy Ste 602
Austin, TX 78735-6757
Phone (512) 893-7265

Other practice location 1

1301 N 47th St
Kansas City, KS 66102-1705
Phone (913) 563-6500

Other identifiers 1

IdentifierTypeStateIssuer
1841281805MedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7236KSMDClinical Social Worker
60328TXMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1219708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593043200000",
    "number": "1003063678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4425 S MO PAC EXPY STE 602",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787356757",
            "telephone_number": "512-893-7265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4425 S MO PAC EXPY STE 602",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787356757",
            "telephone_number": "512-893-7265"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 N 47th St",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "KS",
            "postal_code": "661021705",
            "country_code": "US",
            "telephone_number": "913-563-6500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEGRAFF",
        "first_name": "LISA",
        "middle_name": "KATHERINE",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-26",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KS",
            "license": "7236",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "7236",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "60328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1841281805",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.