Individual provider Active NPI

Lisa Allison Daniel, MSSW

  • Clinical Social Worker
  • Clarksville, TN
National Provider Identifier
1245363266
Registry record updated Nov 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
000003677 Issued in TN
Practice address
1820 Memorial Dr Ste 101
Suite 3
Clarksville, TN 37043-4693
Phone
(931) 553-4161
NPI assigned
Mar 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2011

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 000003677 TN Primary

Addresses

Primary practice location

1820 Memorial Dr Ste 101
Suite 3
Clarksville, TN 37043-4693

Mailing address

1820 Memorial Dr Ste 101
Suite 3
Clarksville, TN 37043-4693
Phone (931) 553-4161

Other names 1

  • Lisa A Daniel Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20120425000312 TN Practitioner - Clinical Social Worker 3971765660 Practice locations: Clarksville, TN

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1820 Memorial Dr
Clarksville, TN 37043-4605
Phone (931) 553-4161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000003677TNMDClinical Social Worker
0000003677TNMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320796800000",
    "number": "1245363266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 MEMORIAL DR STE 101",
            "address_2": "SUITE 3",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370434693",
            "telephone_number": "931-553-4161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 MEMORIAL DR STE 101",
            "address_2": "SUITE 3",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370434693",
            "telephone_number": "931-553-4161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIEL",
        "first_name": "LISA",
        "middle_name": "ALLISON",
        "credential": "MSSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2011-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "000003677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "DANIEL",
            "middle_name": "A",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Clarksville, TN

Sources for this page

Verify at the official NPI Registry.