Individual provider Active NPI

Lisa Dianis, LCSW

  • Clinical Social Worker
  • Stamford, CT
National Provider Identifier
1245505924
Registry record updated Sep 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
006133 Issued in CT
Practice address
22 5TH St
Stamford, CT 06905-5030
Phone
(203) 323-8160
NPI assigned
Mar 14, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R069675-1 NY
Clinical Social Worker 1041C0700X 006133 CT Primary

Addresses

Primary practice location

22 5TH St
Stamford, CT 06905-5030

Mailing address

22 5TH St
Stamford, CT 06905-5030
Phone (203) 323-8160

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240422002802 CT Practitioner - Clinical Social Worker 5092154146 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006133CTMDClinical Social Worker
R069675-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center Inc CurrentSince Apr 15, 2024 Accepting new patients
Community Health Center Inc Clinical Current Accepting new patients

Locations

19 Grand St
Middletown, CT 06457
Phone (860) 323-0172

22 5th St
Stamford, CT 06905
Phone (203) 323-7760

Interoperability endpoints

  • Direct secure messaging: lisa.dianis@chcict.eclinicaldirectplus.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1331683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1245505924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 5TH ST",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069055030",
            "telephone_number": "203-323-8160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 5TH ST",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069055030",
            "telephone_number": "203-323-8160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIANIS",
        "first_name": "LISA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-14",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R069675-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "006133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.