Lisa Ibekwe, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW006976 Issued in GA

Practice address

1091 Overlook Pkwy
Macon, GA 31210

Phone

(470) 242-6140

NPI assigned

Oct 18, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective May 15, 2024 through May 15, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Comfy Place LLC

  • Clinical Social Worker
  • Macon, GA
  • NPI 1548891393
  NPD Authorized official

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

{
    "created_epoch": "1508284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578096000000",
    "number": "1003327933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 BRASS DR",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061043",
            "telephone_number": "678-717-9119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1091 OVERLOOK PKWY",
            "city": "MACON",
            "state": "GA",
            "postal_code": "31210",
            "telephone_number": "470-242-6140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1291 Stanley Rd NW",
            "address_purpose": "LOCATION",
            "city": "Kennesaw",
            "state": "GA",
            "postal_code": "301524359",
            "country_code": "US",
            "telephone_number": "770-427-0147 x2462",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IBEKWE",
        "first_name": "LISA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-18",
        "last_updated": "2020-01-04",
        "certification_date": "2020-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "MSW007359",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW006976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ian Bradley Hair Salon LLC
• Ian Bradley Hair Salon LLC
• Ian Bradley Hair Salon LLC
• Aileen Ibanez-Wong, MPT
• Vanessa Ibeh-Kingsley, PHARMD
• Catherine Ibrahim
• Icare Residential and Community Services
• ICU Specialists, LLC
• Ideal Home Care of Ga
• Koki Ikeda, ATC

• Clinical Social Worker in Macon, GA
• Providers in Macon, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.