Active NPI
Lisa Derosa Hill, LCSW
- Clinical Social Worker
- Wauwatosa, WI
National Provider Identifier
1063505204
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6747-123
- Practice address
- 10045 W Lisbon Ave
Wauwatosa, WI 53222-2446 - Phone
- (414) 358-7144
- Fax
- (414) 358-7158
- NPI assigned
- Oct 2, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6747-123 | WI | Primary |
Addresses
Primary practice location
10045 W Lisbon Ave
Wauwatosa, WI 53222-2446
Mailing address
1648 Hunter Rd
Waukesha, WI 53189-8220
Phone (262) 521-1044
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 30, 2021 through Oct 30, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6747-123 | WI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063505204",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1648 HUNTER RD",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531898220",
"telephone_number": "262-521-1044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10045 W LISBON AVE",
"city": "WAUWATOSA",
"state": "WI",
"postal_code": "532222446",
"telephone_number": "414-358-7144",
"fax_number": "414-358-7158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HILL",
"first_name": "LISA",
"middle_name": "DEROSA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "6747-123",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wauwatosa, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.