Lisa Freeman Tragert, LCSW-C
Individual provider Active NPI Clinical Social Worker · Braddock Heights, MD
NPI 1154944692 · NPPES record last updated May 19, 2020
Key facts
- NPI
- 1154944692
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 05480 (MD)
- Practice address
- 4705 Old Swimming Pool Rd
#625
Braddock Heights, MD 21714-0625 - Phone
- (240) 446-5316
- NPI assigned
- May 19, 2020
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05480 | MD | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 05480 | MD | Yes |
Addresses
Primary practice location
4705 Old Swimming Pool Rd
#625
Braddock Heights, MD 21714-0625
Mailing address
PO Box 625
Braddock Heights, MD 21714-0625
Phone (240) 446-5316
NPI Registry JSON
{
"created_epoch": "1589846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589846400000",
"number": "1154944692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 625",
"city": "BRADDOCK HEIGHTS",
"state": "MD",
"postal_code": "217140625",
"telephone_number": "240-446-5316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4705 OLD SWIMMING POOL RD",
"address_2": "#625",
"city": "BRADDOCK HEIGHTS",
"state": "MD",
"postal_code": "217140625",
"telephone_number": "240-446-5316"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAGERT",
"first_name": "LISA",
"middle_name": "FREEMAN",
"credential": "LCSW-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-05-19",
"last_updated": "2020-05-19",
"certification_date": "2020-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "05480",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Braddock Heights, MD
- Richard Donald McQuarrie
- Heba M I Metwally
- Leslie Pannucci
- South Mountain Rehabilitation Inc
- The Vindobona, Inc.
All providers in Braddock Heights, MD · Clinical Social Worker in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 19, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.