Individual provider Active NPI

Lisa Rosenberg, LCSW

  • Clinical Social Worker
  • Marlton, NJ
National Provider Identifier
1053887364
Registry record updated Sep 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC06005400 Issued in NJ
Practice address
701 Route 70 W # 1032
Marlton, NJ 08053-1643
Phone
(856) 492-4357
NPI assigned
Oct 15, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CW022020 PA
Clinical Social Worker 1041C0700X 44SC06005400 NJ Primary

Addresses

Primary practice location

701 Route 70 W # 1032
Marlton, NJ 08053-1643

Mailing address

701 Route 70 W # 1032
Marlton, NJ 08053-1643
Phone (856) 492-4357

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Oct 9, 2024 through Oct 9, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
44SC06005400NJMDClinical Social Worker
CW022020PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Safe and Included, LLC Clinical CurrentSince Aug 1, 2021 Accepting new patients

Locations

701 Route 70 W
Marlton, NJ 08053
Phone (732) 522-6189

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": "1539561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1053887364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 ROUTE 70 W # 1032",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080531643",
            "telephone_number": "856-492-4357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 ROUTE 70 W # 1032",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080531643",
            "telephone_number": "856-492-4357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "LISA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-15",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW022020",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06005400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

Verify at the official NPI Registry.