Individual provider Active NPI

Jennifer Beth Lasker, MSW

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1174740716
Registry record updated Dec 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C004142 Issued in NC
Practice address
8430 University Exec Park Dr
Suite 655
Charlotte, NC 28262-1350
Phone
(704) 596-5553
Fax
(704) 596-1556
NPI assigned
Apr 18, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2011

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 CW014487 PA
Clinical Social Worker 1041C0700X C004142 NC Primary

Addresses

Primary practice location

8430 University Exec Park Dr
Suite 655
Charlotte, NC 28262-1350

Mailing address

8430 University Exec Park Dr
Suite 655
Charlotte, NC 28262-1350
Phone (704) 596-5553

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW014487PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Connections BWB Inc Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324512000000",
    "number": "1174740716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8430 UNIVERSITY EXEC PARK DR",
            "address_2": "SUITE 655",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282621350",
            "telephone_number": "704-596-5553",
            "fax_number": "704-596-1556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8430 UNIVERSITY EXEC PARK DR",
            "address_2": "SUITE 655",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282621350",
            "telephone_number": "704-596-5553",
            "fax_number": "704-596-1556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASKER",
        "first_name": "JENNIFER",
        "middle_name": "BETH",
        "name_prefix": "Prof.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2011-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW014487",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C004142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2011; 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.