Active NPI
Lisa Jeannette Mader, LCSW
- Clinical Social Worker
- San Diego, CA
National Provider Identifier
1174790349
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 2487
- Practice address
- 9791 Mesa Springs Way
#80
San Diego, CA 92126-4150 - Phone
- (619) 209-9989
- NPI assigned
- May 15, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2487 | KS | Primary |
Addresses
Primary practice location
9791 Mesa Springs Way
#80
San Diego, CA 92126-4150
Mailing address
9791 Mesa Springs Way
#80
San Diego, CA 92126-4150
Phone (619) 209-9989
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210809600000",
"number": "1174790349",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9791 MESA SPRINGS WAY",
"address_2": "#80",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921264150",
"telephone_number": "619-209-9989"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9791 MESA SPRINGS WAY",
"address_2": "#80",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921264150",
"telephone_number": "619-209-9989"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADER",
"first_name": "LISA",
"middle_name": "JEANNETTE",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-15",
"last_updated": "2008-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "KS",
"license": "2487",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.