Individual provider Active NPI

Lisa Marie Carpenter, LCSW, MSW, LICSW

  • Clinical Social Worker
  • Vancouver, WA
National Provider Identifier
1114047636
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW00006230 Issued in WA
Practice address
3200 NE 109TH Ave
Vancouver, WA 98682-7749
Phone
(360) 695-1014
Fax
(360) 750-1374
NPI assigned
Mar 29, 2007
Last updated
Oct 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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 L2652 OR
Clinical Social Worker 1041C0700X LW00006230 WA Primary

Addresses

Primary practice location

3200 NE 109TH Ave
Vancouver, WA 98682-7749

Mailing address

1014 Main Street
Vancouver, WA 98661
Phone (360) 695-1014

Other names 1

  • Lisa M Catt Former name

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
L2652ORMDClinical Social Worker
LW00006230WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Solutions, Inc CurrentSince Mar 26, 2023 Accepting new patients

Locations

1014 Main St
Vancouver, WA 98660
Phone (360) 695-1014

3200 NE 109th Ave
Vancouver, WA 98682
Phone (360) 695-1014

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/family-solutions/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1114047636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 MAIN STREET",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98661",
            "telephone_number": "360-695-1014",
            "fax_number": "360-750-1374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 NE 109TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986827749",
            "telephone_number": "360-695-1014",
            "fax_number": "360-750-1374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LCSW, MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L2652",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00006230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "CATT",
            "middle_name": "M",
            "credential": "LCSW, MSW, LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; 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.