Lisa Young, CSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW017594 Issued in PA

Practice address

408 E. Fourth Street
Suite 206
Bridgeport, PA 19405

Phone

(215) 313-0086

Fax

(610) 867-7180

NPI assigned

Jun 23, 2014

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

Other names 1

• Lisa Roling Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Distracted Therapist

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wyomissing, PA
  • NPI 1972499465
  NPD Authorized official

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

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493942400000",
    "number": "1154736783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 E. FOURTH STREET",
            "address_2": "SUITE 206",
            "city": "BRIDGEPORT",
            "state": "PA",
            "postal_code": "19405",
            "telephone_number": "215-313-0086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 E. FOURTH STREET",
            "address_2": "SUITE 206",
            "city": "BRIDGEPORT",
            "state": "PA",
            "postal_code": "19405",
            "telephone_number": "215-313-0086",
            "fax_number": "610-867-7180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "LISA",
        "credential": "CSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-23",
        "last_updated": "2017-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW017594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "ROLING",
            "credential": "CSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Eric Anthony Sibilla, DPT
• Nathalie Wilson, MPT
• Samantha Wong, D.M.D.
• Workers First Clinical Services LLC
• Workers First Pharmacy Services LLC

• All providers in Bridgeport, PA
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2017; 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.