NPIMap

Organization Active NPI

Lisa Tortorello Gilligan MSW LCSW LLC

  • Clinical Social Worker
  • Woodbridge, NJ
National Provider Identifier
1194160507
Registry record updated Oct 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05364900 Issued in NJ
Legal business name
LISA TORTORELLO GILLIGAN MSW LCSW LLC
Practice address
300 Kimball St
Woodbridge, NJ 07095-2513
Phone
(732) 609-0169
Fax
(732) 218-8601
NPI assigned
Apr 30, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2020

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

Authorized official

Name
Lisa Marie Tortorello-GilliganNPI 1528209384
Title
Owner
Phone
(732) 609-0169

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 44SC05364900 NJ Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

300 Kimball St
Woodbridge, NJ 07095-2513

Mailing address

300 Kimball St Ste 106
Woodbridge, NJ 07095-2506
Phone (732) 609-0169

Other identifiers 1

IdentifierTypeStateIssuer
AETNAOtherAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230510000078 NJ Part B Supplier - Clinic/Group Practice 7113383530 Receives reassigned benefits from 2 practitioners
Practice locations: Woodbridge, NJ

National Provider Directory

National Provider Directory

Locations

300 Kimball St
Ste 106
Woodbridge, NJ 07095
Phone (732) 218-8600

705 Amboy Ave
Ste B
Woodbridge, NJ 07095
Phone (732) 609-0169

300 Kimball St
Woodbridge, NJ 07095
Phone (732) 609-0169

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1367280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602201600000",
    "number": "1194160507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 KIMBALL ST STE 106",
            "city": "WOODBRIDGE",
            "state": "NJ",
            "postal_code": "070952506",
            "telephone_number": "732-609-0169",
            "fax_number": "732-218-8601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 KIMBALL ST",
            "city": "WOODBRIDGE",
            "state": "NJ",
            "postal_code": "070952513",
            "telephone_number": "732-609-0169",
            "fax_number": "732-218-8601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA TORTORELLO GILLIGAN MSW LCSW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-30",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-08",
        "status": "A",
        "authorized_official_last_name": "TORTORELLO-GILLIGAN",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-609-0169"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05364900",
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "AETNA",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.