Individual provider Active NPI

Lisa Fannin, MSW, LSW

  • Social Worker
  • Columbus, OH
National Provider Identifier
1154884179
Registry record updated Apr 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
S.0900772 Issued in OH
Practice address
750 E Long St Ste 3000
Columbus, OH 43203-1874
Phone
(614) 340-6693
NPI assigned
Apr 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S.0900772 OH Primary

Addresses

Primary practice location

750 E Long St Ste 3000
Columbus, OH 43203-1874

Mailing address

750 E Long St Ste 3000
Columbus, OH 43203-1874
Phone (614) 340-6693

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
S.0900772OHMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554681600000",
    "number": "1154884179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 E LONG ST STE 3000",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432031874",
            "telephone_number": "614-340-6693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E LONG ST STE 3000",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432031874",
            "telephone_number": "614-340-6693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANNIN",
        "first_name": "LISA",
        "credential": "MSW, LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-08",
        "last_updated": "2019-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.0900772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2019; 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.