Individual provider Active NPI

Lesley Sanfilippo, LSW

  • Clinical Social Worker
  • Red Bank, NJ
National Provider Identifier
1215221270
Registry record updated Oct 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
09924765 Issued in CO
Practice address
270 Highway 35
Red Bank, NJ 07701-5920
Phone
(732) 842-2000
Fax
(732) 212-2890
NPI assigned
Jun 7, 2011
Last updated
Oct 12, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 44SL05694000 NJ
Clinical Social Worker 1041C0700X 09924765 CO Primary

Addresses

Primary practice location

270 Highway 35
Red Bank, NJ 07701-5920

Mailing address

4115 Boardwalk Dr
Unit 100
Fort Collins, CO 80525-5945
Phone (732) 842-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181024002938 CO Practitioner - Clinical Social Worker 0840427563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4115 Boardwalk Dr
Unit 100
Fort Collins, CO 80525-5945
Phone (970) 493-4580

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SL05694000NJMDMental Health Counselor
09924765COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Neurofeedback Clinic of Northern Colorado LLC Clinical CurrentSince Sep 12, 2018 Accepting new patients
Neurofeedback Clinic of Northern Colorado LLC Clinical CurrentSince Sep 12, 2018 Accepting new patients

Locations

4115 Boardwalk Dr
Unit 100
Fort Collins, CO 80525
Phone (970) 493-4580

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1307404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539302400000",
    "number": "1215221270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4115 BOARDWALK DR",
            "address_2": "UNIT 100",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255945",
            "telephone_number": "732-842-2000",
            "fax_number": "732-212-2890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 HIGHWAY 35",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077015920",
            "telephone_number": "732-842-2000",
            "fax_number": "732-212-2890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANFILIPPO",
        "first_name": "LESLEY",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-07",
        "last_updated": "2018-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "44SL05694000",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "09924765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Bank, NJ

Sources for this page

Verify at the official NPI Registry.