Individual provider Active NPI

Lissa Mantell, LICSW, LCSW-C

  • Clinical Social Worker
  • Silver Spring, MD
National Provider Identifier
1154617587
Registry record updated Oct 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
17898 Issued in MD
Practice address
8609 2ND Ave Ste 307B
Silver Spring, MD 20910-3361
Phone
(301) 960-8546
NPI assigned
Jun 23, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2013

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 17898 MD Primary
Clinical Social Worker 1041C0700X LC50078920 DC

Addresses

Primary practice location

8609 2ND Ave Ste 307B
Silver Spring, MD 20910-3361

Mailing address

8609 2ND Ave Ste 307B
Silver Spring, MD 20910-3361
Phone (301) 960-8546

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
LC50078920DCMDClinical Social Worker
17898MDMDOrthopedic Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380758400000",
    "number": "1154617587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8609 2ND AVE STE 307B",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209103361",
            "telephone_number": "301-960-8546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8609 2ND AVE STE 307B",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209103361",
            "telephone_number": "301-960-8546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTELL",
        "first_name": "LISSA",
        "credential": "LICSW, LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-23",
        "last_updated": "2013-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "17898",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC50078920",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2013; 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.