Individual provider Active NPI

Lisa Marie Brown, LCSW

  • Clinical Social Worker
  • Hazlet, NJ
National Provider Identifier
1114139482
Registry record updated Nov 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05303700 Issued in NJ
Practice address
41 Village CT
Hazlet, NJ 07730-1535
Phone
(732) 740-8983
NPI assigned
May 7, 2007
Last updated
Nov 30, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC05303700 NJ Primary

Addresses

Primary practice location

41 Village CT
Hazlet, NJ 07730-1535

Mailing address

41 Village CT
Hazlet, NJ 07730-1535
Phone (732) 740-8983

Other practice location 1

200 Wycoff Road
Eatontown NJ, NJ 07724
Phone (888) 244-5373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260623004958 NJ Practitioner - Clinical Social Worker 4688147481 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1899 W Custer LN
Fayetteville, AR 72701-6777

379 Campus Dr
Somerset, NJ 08873-1161

66 W Gilbert St
Suite 200
Red Bank, NJ 07701-4948

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC05303700NJMDClinical Social Worker

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": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1114139482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 VILLAGE CT",
            "city": "HAZLET",
            "state": "NJ",
            "postal_code": "077301535",
            "telephone_number": "732-740-8983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 VILLAGE CT",
            "city": "HAZLET",
            "state": "NJ",
            "postal_code": "077301535",
            "telephone_number": "732-740-8983"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Wycoff Road",
            "address_purpose": "LOCATION",
            "city": "Eatontown NJ",
            "state": "NJ",
            "postal_code": "07724",
            "country_code": "US",
            "telephone_number": "888-244-5373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-07",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05303700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazlet, NJ

Sources for this page

Verify at the official NPI Registry.