Lisa May Edmondson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C005608 Issued in NC

Practice address

106 N 1St Ave
Suite a
Knightdale, NC 27545-8093

Phone

(919) 210-4176

Fax

(877) 757-4728

NPI assigned

Mar 12, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Clinical Social Worker

Education

Other, 1997

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433980800000",
    "number": "1265564645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 ARBOR RIDGE CT",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275459202",
            "telephone_number": "919-210-4176",
            "fax_number": "877-757-4728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 N 1ST AVE",
            "address_2": "SUITE A",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275458093",
            "telephone_number": "919-210-4176",
            "fax_number": "877-757-4728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMONDSON",
        "first_name": "LISA",
        "middle_name": "MAY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-12",
        "last_updated": "2015-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C005608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6106593",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tammy Earley
• East Wake Counseling and Consulting, PLLC
• East Wake Home Care
• Mahtsente Worku Ebron, MSHS OTRL
• Madeline Sarah Eck, BCBA
• Lacrysha Foreman Edmundson, RN
• Elevate Medical Supplies LLC
• Elite Therapeutic Services
• Christopher Ellenberger, DPT
• Elmore Center for Physical Therapy and Lymphedema Services

• Clinical Social Worker in Knightdale, NC
• Providers in Knightdale, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.