Organization Active NPI

Lisa R. Ahmed, Licsw, LLC

  • Mental Health Counselor
  • Needham, MA
National Provider Identifier
1063179406
Registry record updated Nov 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
LISA R. AHMED, LICSW, LLC
Practice address
4 Oak St Ste 2
Needham, MA 02492-2462
Phone
(781) 400-1143
NPI assigned
Nov 19, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2021

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

Authorized official

Name
Ms. Lisa AhmedNPI 1295710549
Title
Therapist
Phone
(781) 400-1143

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

4 Oak St Ste 2
Needham, MA 02492-2462

Mailing address

4 Oak St Ste 2
Needham, MA 02492-2462

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220712000840 MA Part B Supplier - Clinic/Group Practice 1759761497 Receives reassigned benefits from 1 practitioner
Practice locations: Needham, MA

National Provider Directory

National Provider Directory

Locations

4 Oak St
Ste 2
Needham, MA 02492
Phone (781) 400-1143

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1637280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637280000000",
    "number": "1063179406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 OAK ST STE 2",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024922462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 OAK ST STE 2",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024922462",
            "telephone_number": "781-400-1143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA R. AHMED, LICSW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-19",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A",
        "authorized_official_last_name": "AHMED",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "781-400-1143",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Needham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.