Lisa Wackerman Iwanowski, LCSW,MSW,BA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

4411 Issued in CT

Practice address

1275 Post Rd Ste A11
Fairfield, CT 06824-6061

Phone

(203) 257-6047

NPI assigned

Jul 18, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 13

Medicare fee-for-service enrollment

Enrolled in CT

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

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Arts

State licenses

Practice roles

Locations

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.

• Step Up Care PC LLC

  • Counselor
  • Danielson, CT
  • NPI 1154884740
  Medicare reassignment NPD

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

{
    "created_epoch": "1216339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545955200000",
    "number": "1235394263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 POST RD STE A11",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068246061",
            "telephone_number": "203-257-6047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 POST RD STE A11",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068246061",
            "telephone_number": "203-257-6047"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "141 E Main St",
            "address_2": "Home Base Services-3rd Floor",
            "address_purpose": "LOCATION",
            "city": "Waterbury",
            "state": "CT",
            "postal_code": "067022310",
            "country_code": "US",
            "telephone_number": "203-575-0466 x1135",
            "fax_number": "203-575-1817",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IWANOWSKI",
        "first_name": "LISA",
        "middle_name": "WACKERMAN",
        "name_prefix": "Mrs.",
        "credential": "LCSW,MSW,BA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-18",
        "last_updated": "2018-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "4411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12427443",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA BEHAVIORAL HEALTH",
            "identifier": "PENDING",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN MANAGED HEALTH NETWORK",
            "identifier": "PENDING",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS OF CT    WELLMORE GRP/FACILITY",
            "identifier": "060669107",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH-CONNECTICARE            WELLMORE GRP/FACILITY",
            "identifier": "060669107",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BEHAVIORAL HEALTH",
            "identifier": "4299867",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008057192",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH- UNITED HEALTHCARE               WELLMORE GRP/FACILITY",
            "identifier": "060669107",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH-OXFORD FREEDOM/LIBERTY             WELLMORE GRP/FACILITY",
            "identifier": "060669107",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHYCT             WELLMORE GRP/FACILITY",
            "identifier": "060669107",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEACON HEALTH STRATEGIES",
            "identifier": "D339123-141 E MAIN",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN TRICARENORTH",
            "identifier": "PENDING",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTUM BEHAVIORAL HEALTH/UBH     WELLMORE GRP/FACILITY",
            "identifier": "060669107",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Institute for Ayurvedic and Naturopathic Therapies
• Bridget Instrum, PA-C
• Integrated Medical Center
• David Paul Isenberg, PHD
• Kathleen Istvan, SLP
• J & L Medical Services, LLC
• Gina Jacobson, OTR/L
• Melissa Jagoe-Seidl
• Monica M Jain, MD
• Theodora Barber Jameson, PT

• Clinical Social Worker in Fairfield, CT
• Providers in Fairfield, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.