Individual provider Active NPI

Lisa Erin Gold, LCSW

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1063716561
Registry record updated Oct 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS62882 Issued in CA
Practice address
4099 N. Mission Road
Los Angeles, CA 90032
Phone
(323) 221-1746
Fax
(323) 221-5176
NPI assigned
Dec 27, 2010
Last updated
Oct 20, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2014

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 ACSW 28499 CA
Clinical Social Worker 1041C0700X LCS62882 CA Primary

Addresses

Primary practice location

4099 N. Mission Road
Los Angeles, CA 90032

Mailing address

4099 N. Mission Road
Los Angeles, CA 90032
Phone (323) 221-1746

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ACSW 28499CAMDClinical Social Worker
LCS62882CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1293408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413763200000",
    "number": "1063716561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4099 N. MISSION ROAD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90032",
            "telephone_number": "323-221-1746",
            "fax_number": "323-221-5176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4099 N. MISSION ROAD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90032",
            "telephone_number": "323-221-1746",
            "fax_number": "323-221-5176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLD",
        "first_name": "LISA",
        "middle_name": "ERIN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-27",
        "last_updated": "2014-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ACSW 28499",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS62882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2014; 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.