Organization Active NPI

Lisa J. Snow, LCSW, LLC

  • Clinical Social Worker
  • Mexico, MO
National Provider Identifier
1013381276
Registry record updated Dec 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2013025364 Issued in MO
Legal business name
LISA J. SNOW, LCSW, LLC
Practice address
314 E Promenade St
Mexico, MO 65265-2857
Phone
(573) 975-4301
Fax
(573) 975-4304
NPI assigned
Nov 25, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2023

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

Authorized official

Name
Lisa Snow, LCSWNPI 1750705638
Title
Provider
Phone
(573) 975-4301

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 2013025364 MO Primary

Addresses

Primary practice location

314 E Promenade St
Mexico, MO 65265-2857

Mailing address

314 E Promenade St
Mexico, MO 65265-2857
Phone (573) 975-4301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160425000817 MO Part B Supplier - Clinic/Group Practice 2163721283 Receives reassigned benefits from 1 practitioner
Practice locations: Mexico, MO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1448409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702771200000",
    "number": "1013381276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 E PROMENADE ST",
            "city": "MEXICO",
            "state": "MO",
            "postal_code": "652652857",
            "telephone_number": "573-975-4301",
            "fax_number": "573-975-4304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 E PROMENADE ST",
            "city": "MEXICO",
            "state": "MO",
            "postal_code": "652652857",
            "telephone_number": "573-975-4301",
            "fax_number": "573-975-4304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA J. SNOW, LCSW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-25",
        "last_updated": "2023-12-17",
        "certification_date": "2023-12-17",
        "status": "A",
        "authorized_official_last_name": "SNOW",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "573-975-4301",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2013025364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mexico, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.