Lisa Hatch Timberlake, LCSWA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P017086 Issued in NC

Practice address

3006 McQueen Dr
Durham, NC 27705-8801

Phone

(717) 940-9635

NPI assigned

May 12, 2015

Last updated

Oct 8, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Clinical Social Worker

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Alberta Professional Services, Inc

  • Community/Behavioral Health Agency
  • Greensboro, NC
  • NPI 1619613536
  Medicare reassignment
• Alberta Professional Services

  • Foster Care Agency
  • Greensboro, NC
  • NPI 1336506146
  NPD (past)
• Jewish Family Services of York

  • Community/Behavioral Health Agency
  • York, PA
  • NPI 1306059472
  NPD (past)

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

{
    "created_epoch": "1431388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1144608027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3107 S ELM EUGENE ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274065297",
            "telephone_number": "336-273-2640",
            "fax_number": "336-273-6522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3006 MCQUEEN DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277058801",
            "telephone_number": "717-940-9635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIMBERLAKE",
        "first_name": "LISA",
        "middle_name": "HATCH",
        "credential": "LCSWA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-12",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P017086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Matthew Tighe, M.D.
• Geanda Tilley
• Rachael Kathryn Tilley
• Frank Tillman III, PHARMD
• Ellen Tim, NP
• Tina Young LCSW PLLC
• Virginia Fay Tindley
• Sherwin Charng-Shiow Ting, M.D.
• Qionna Mariel Tinney, M.D.
• Sarah Tintle, PT

• Clinical Social Worker in Durham, NC
• Providers in Durham, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.