Lisa Vinnacombe, MSS, MLSP, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW019591 Issued in PA

Practice address

2133 Arch St Ste 302
Philadelphia, PA 19103-1479

Phone

(484) 367-5808

NPI assigned

Mar 14, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Bloomgarden & Associates

  • Clinical Psychologist
  • Philadelphia, PA
  • NPI 1184800849
  NPD (past)

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

{
    "created_epoch": "1457913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1194186411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2133 ARCH ST STE 302",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191031479",
            "telephone_number": "484-367-5808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2133 ARCH ST STE 302",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191031479",
            "telephone_number": "484-367-5808"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "230 S Broad St Ste 1305",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191024104",
            "country_code": "US",
            "telephone_number": "215-545-1175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VINNACOMBE",
        "first_name": "LISA",
        "credential": "MSS, MLSP, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-14",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW128855",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW019591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vine Street Medical and Associates
• Vine Street Medical and Associates
• Taylor Viniarski
• Kyle Holmberg Vining, D.D.S.
• Marvin Vinluan, CRNA
• Christopher Lawrence Vinnard, M.D.
• Alexandra Miller Vinograd, MD
• Yelena Vinogradov, DMD
• Sophia S Vinogradovf, M.D.
• Emma Vinokur, BE

• Clinical Social Worker in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; 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.