Lisa Beneventano, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

088439 Issued in NY

Practice address

215 Hallock Rd Ste 1a
Stony Brook, NY 11790-3079

Phone

(631) 551-5095

NPI assigned

May 12, 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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1494547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622332800000",
    "number": "1013444702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 FORSYTHE MEADOW LN",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117901842",
            "telephone_number": "914-450-2768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 HALLOCK RD STE 1A",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117903079",
            "telephone_number": "631-551-5095"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Forsythe Meadow Ln",
            "address_purpose": "LOCATION",
            "city": "Stony Brook",
            "state": "NY",
            "postal_code": "117901842",
            "country_code": "US",
            "telephone_number": "914-450-2768",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENEVENTANO",
        "first_name": "LISA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-12",
        "last_updated": "2021-05-30",
        "certification_date": "2021-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "079372",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "088439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raymond Matthew Bellis, MD
• Lourdes Alicia Bello Espinosa, M.D
• Travis James Bench, MD
• Sara Bendig, PA-C
• Christy Anne Beneri, DO
• Caroline Rose Benish McNamara, NP
• Alexander Benitt, MD
• Elliott Bennett-Guerrero, M.D.
• Lesley Anne Bennici, M.D.
• Taylor Nicole Bentz

• Clinical Social Worker in Stony Brook, NY
• Providers in Stony Brook, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2021; 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.