Individual provider Active NPI

Lisa Neverdausky, LMSW, CAADC

  • Clinical Social Worker
  • Livonia, MI
National Provider Identifier
1245354984
Registry record updated Aug 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801090168 Issued in MI
Practice address
29550 Five Mile Rd
Livonia, MI 48154-3710
Phone
(800) 395-3223
NPI assigned
Mar 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801090168 MI Primary

Addresses

Primary practice location

29550 Five Mile Rd
Livonia, MI 48154-3710

Mailing address

160 N Roosevelt St Apt 203
Canton, MI 48187-4894
Phone (810) 813-0271

Other identifiers 1

IdentifierTypeStateIssuer
213119549MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20111025000352 MI Practitioner - Clinical Social Worker 0648443358 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

484 Deer St
Plymouth, MI 48170-1747
Phone (810) 813-0271

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
LDBT, LLC Clinical CurrentSince Feb 6, 2024 Accepting new patients
Growth Works, Inc PastSince Apr 1, 2026 Accepting new patients
Growth Works Inc. Past Accepting new patients

Locations

36216 Freedom Rd
Farmington Hills, MI 48335
Phone (248) 514-2366

484 Deer St
Plymouth, MI 48170
Phone (734) 301-1662

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691712000000",
    "number": "1245354984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 N ROOSEVELT ST APT 203",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481874894",
            "telephone_number": "810-813-0271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29550 FIVE MILE RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481543710",
            "telephone_number": "800-395-3223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEVERDAUSKY",
        "first_name": "LISA",
        "name_prefix": "Ms.",
        "credential": "LMSW, CAADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801090168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213119549",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.