Individual provider Active NPI

Lisa Freeman Tragert, LCSW-C

  • Clinical Social Worker
  • Braddock Heights, MD
National Provider Identifier
1154944692
Registry record updated May 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
05480 Issued in MD
Practice address
4705 Old Swimming Pool Rd
#625
Braddock Heights, MD 21714-0625
Phone
(240) 446-5316
NPI assigned
May 19, 2020
Last updated
May 19, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 05480 MD Primary

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

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
05480MDMDClinical Social Worker

NPI Registry JSON

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

{
    "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

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2020; 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.