Lisa Johnson Reid, LCSW-A

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1013514587 Issued in NC

Practice address

3491 Evans St Ste B
Greenville, NC 27834-4534

Phone

(252) 364-2321

NPI assigned

Oct 7, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• A Fresh Start Behavioral Health Services, PLLC

  • Clinical Social Worker
  • New Bern, NC
  • NPI 1710499223
  NPD (past)

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

{
    "created_epoch": "1602028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1013514587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3491 EVANS ST STE B",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278344534",
            "telephone_number": "252-364-2321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3491 EVANS ST STE B",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278344534",
            "telephone_number": "252-364-2321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2407 Grace Ave",
            "address_purpose": "LOCATION",
            "city": "New Bern",
            "state": "NC",
            "postal_code": "285624416",
            "country_code": "US",
            "telephone_number": "252-638-0185",
            "fax_number": "844-272-4550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REID",
        "first_name": "LISA",
        "middle_name": "JOHNSON",
        "name_prefix": "Ms.",
        "credential": "LCSW-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-07",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NC",
            "license": "P15282",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NC",
            "license": "P15282",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "1013514587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Kay Register
• Zia Ur Rehman, MD
• Anyah Reid
• Casey C Reid, COTA
• Emily Renee Schoen Reid, OTR/L
• Helene Reilly, F.N.P.
• Garrett Austin Reinhard, CRNA
• Margaret Reither, CNM
• John Wayne Reitnauer III, MD
• Reliable Respiratory Therapy

• Clinical Social Worker in Greenville, NC
• Providers in Greenville, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; 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.