Individual provider Active NPI

Melinda Lisny, LCSW,LCADC

  • Addiction (Substance Use Disorder) Counselor
  • Matawan, NJ
National Provider Identifier
1114076668
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
37LC00082500 Issued in NJ
Practice address
166 Main St
Matawan, NJ 07747-3104
Phone
(732) 290-9040
NPI assigned
Jan 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 37LC00082500 NJ Primary
Clinical Social Worker 1041C0700X 44SC05265900 NJ

Addresses

Primary practice location

166 Main St
Matawan, NJ 07747-3104

Mailing address

114 Mount Tabor Way
Ocean Grove, NJ 07756-1414
Phone (732) 774-0014

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
37LC00082500NJMDAddiction (Substance Use Disorder) Counselor
44SC05265900NJMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1114076668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 MOUNT TABOR WAY",
            "city": "OCEAN GROVE",
            "state": "NJ",
            "postal_code": "077561414",
            "telephone_number": "732-774-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 MAIN ST",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077473104",
            "telephone_number": "732-290-9040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISNY",
        "first_name": "MELINDA",
        "credential": "LCSW,LCADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00082500",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05265900",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Matawan, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.