Individual provider Active NPI

Lisa J Daponte, MSW, LICSW

  • Clinical Social Worker
  • Providence, RI
National Provider Identifier
1114214012
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW02399 Issued in RI
Practice address
270 Elmwood Ave
Providence, RI 02907-1524
Phone
(401) 274-8811
Fax
(401) 274-8877
NPI assigned
Jun 30, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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 117685 MA
Clinical Social Worker 1041C0700X ISW02399 RI Primary

Addresses

Primary practice location

270 Elmwood Ave
Providence, RI 02907-1524

Mailing address

270 Elmwood Ave
Providence, RI 02907-1524
Phone (401) 274-8811

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
117685MAMDClinical Social Worker
ISW02399RIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Southeast Asians CurrentSince Sep 5, 2023 Accepting new patients
High Point Treatment Center Inc. Past Accepting new patients
Maxim Healthcare Services Inc PastSince Sep 5, 2023 Accepting new patients

Locations

270 Elmwood Ave
Providence, RI 02907
Phone (401) 274-8811

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1309392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1114214012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 ELMWOOD AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029071524",
            "telephone_number": "401-274-8811",
            "fax_number": "401-274-8877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 ELMWOOD AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029071524",
            "telephone_number": "401-274-8811",
            "fax_number": "401-274-8877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAPONTE",
        "first_name": "LISA",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-30",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "117685",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW02399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; 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.