Liza Jayne Drake, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

7220123 Issued in WI

Practice address

W4051 County Road NN
Elkhorn, WI 53121-4338

Phone

(262) 741-3200

Fax

(262) 741-3315

NPI assigned

Jul 15, 2006

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 2, 2010.

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267488000000",
    "number": "1023035474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7432 W BLUEMOUND RD",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532133655",
            "telephone_number": "414-807-3477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W4051 COUNTY ROAD NN",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "531214338",
            "telephone_number": "262-741-3200",
            "fax_number": "262-741-3315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAKE",
        "first_name": "LIZA",
        "middle_name": "JAYNE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-15",
        "last_updated": "2010-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7220123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00264098",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40914700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Elkhorn, WI
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2010; 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.