Individual provider Active NPI

Lisa Michelle Lassen, LCSW

  • Clinical Social Worker
  • San Antonio, TX
National Provider Identifier
1003389099
Registry record updated Jan 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
62512 Issued in TX
Practice address
4242 Medical Dr Ste 6300
San Antonio, TX 78229-5372
Phone
(210) 614-8400
Fax
(210) 614-8165
NPI assigned
Jan 2, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 62512 TX Primary

Addresses

Primary practice location

4242 Medical Dr Ste 6300
San Antonio, TX 78229-5372

Mailing address

4242 Medical Dr Ste 6300
San Antonio, TX 78229-5372
Phone (210) 614-8400

Other names 1

  • Lisa Michelle Castillo Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4242 Medical Dr
San Antonio, TX 78229-5329

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Behavioral Health, PLLC Clinical CurrentSince Jan 25, 2021 Accepting new patients

Locations

4242 Medical Dr
Ste 6300
San Antonio, TX 78229
Phone (210) 614-8400

Networks

  • NM HMO C-SNP
  • TX HMO
  • TX HMO D-SNP

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1546387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546387200000",
    "number": "1003389099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4242 MEDICAL DR STE 6300",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782295372",
            "telephone_number": "210-614-8400",
            "fax_number": "210-614-8165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4242 MEDICAL DR STE 6300",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782295372",
            "telephone_number": "210-614-8400",
            "fax_number": "210-614-8165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASSEN",
        "first_name": "LISA",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-02",
        "last_updated": "2019-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "62512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "CASTILLO",
            "middle_name": "MICHELLE",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.