Individual provider Active NPI

Lisa Cheryl List, LCSW

  • Clinical Social Worker
  • New City, NY
National Provider Identifier
1245952522
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
10 Avon LN
New City, NY 10956-4031
Phone
(201) 341-1844
NPI assigned
Sep 14, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2022

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 Primary

Addresses

Primary practice location

10 Avon LN
New City, NY 10956-4031

Mailing address

10 Avon LN
New City, NY 10956-4031
Phone (201) 341-1844

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20221108002032 NY Practitioner - Clinical Social Worker 5890162689 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Senior Living Behavioral Health LCSW PLLCGroup PAC ID 9931482247, 17 clinicians

Practice addresses (Care Compare)

1065 Smithtown Ave
Bohemia, NY 11716-3800
Phone (631) 567-3113

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071678NYMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Living Behavioral Health LCSW PLLC Clinical CurrentSince Sep 1, 2022 Accepting new patients

Locations

1065 Smithtown Ave
Bohemia, NY 11716
Phone (631) 388-7616

Organizations & group practices 1

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": "1663113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1245952522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 AVON LN",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109564031",
            "telephone_number": "201-341-1844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 AVON LN",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109564031",
            "telephone_number": "201-341-1844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIST",
        "first_name": "LISA",
        "middle_name": "CHERYL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-14",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New City, NY

Sources for this page

Verify at the official NPI Registry.