Liza P Brackbill, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LICSW1121002 Issued in MA

Practice address

255 Low St Ste 302
Newburyport, MA 01950-3596

Phone

(978) 222-3121

NPI assigned

Nov 15, 2021

Sex

Female

Sole proprietor

No

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

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optum Behavioral Care of Connecticut PCGroup PAC ID 9436502879, 132 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Optum Behavioral Care of Connecticut, P.C.

  • Counseling Psychologist
  • Newburyport, MA
  • NPI 1831970904
  Medicare reassignment Care Compare group NPD
• Pathways & Possibilities Counseling Services LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Medford, MA
  • NPI 1790679561
  Medicare reassignment NPD Authorized official
• Optum Behavioral Care of Connecticut, P.C.

  • Counseling Psychologist
  • Boston, MA
  • NPI 1235811787
  NPD
• Optum Behavioral Care of Connecticut, P.C.

  • Clinical Social Worker
  • Providence, RI
  • NPI 1730972944
  NPD

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

{
    "created_epoch": "1636934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1063178010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 LOW ST STE 302",
            "city": "NEWBURYPORT",
            "state": "MA",
            "postal_code": "019503596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 LOW ST STE 302",
            "city": "NEWBURYPORT",
            "state": "MA",
            "postal_code": "019503596",
            "telephone_number": "978-222-3121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACKBILL",
        "first_name": "LIZA",
        "middle_name": "P",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-15",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "LCSW228504",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "LICSW1121002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammy B Bottner, M.D.
• Katherine Anne Bourne, MD
• Kelly Bowen
• Zachary David Bowen, DMD
• Natasha Victoria Boydstun, DO
• Brain-Mind Institute of New England
• Donna J Brezinski, M.D.
• Jeremy Brooks, PSYD
• Kennedy Lyn Brown, DC
• Janine Susan Brunell, BA

• Clinical Social Worker in Newburyport, MA
• Providers in Newburyport, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.