Individual provider Active NPI

Lisa Rene' Phelps

  • Clinical Social Worker
  • Jamaica Plain, MA
National Provider Identifier
1285141523
Registry record updated Jan 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
119536 Issued in MA
Practice address
1153 Centre St Ste 5J
Jamaica Plain, MA 02130-3446
Phone
(617) 983-7383
NPI assigned
Jan 9, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2018

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 119536 MA Primary

Addresses

Primary practice location

1153 Centre St Ste 5J
Jamaica Plain, MA 02130-3446

Mailing address

1303 Station Cir
Dedham, MA 02026-4585
Phone (339) 225-1648

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20180219002535 MA Practitioner - Clinical Social Worker 0143581991 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Renz Counseling, LLCGroup PAC ID 0042533259, 11 clinicians

Practice addresses (Care Compare)

1153 Centre St
Jamaica Plain, MA 02130-3446
Phone (617) 983-7000

378 Page St
Suite 6
Stoughton, MA 02072-1124
Phone (339) 364-8080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
119536MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Renz Counseling, LLC Clinical CurrentSince Oct 20, 2022 Accepting new patients
Brigham & Womens Hospital, Inc. CurrentSince Jan 25, 2018 Accepting new patients
Brigham and Women's Faulkner Hospital, Inc Current Accepting new patients
Brigham & Womens Physicians Organization Inc CurrentSince Jan 25, 2018 Accepting new patients

Locations

75 Francis St
Boston, MA 02115

375 Boylston St
Brookline, MA 02445
Phone (508) 718-4010

1032 Turnpike St
Ste 204
Canton, MA 02021
Phone (339) 364-8080

1153 Centre St
Ste 5J
Jamaica Plain, MA 02130
Phone (617) 983-7300

1153 Centre St
Jamaica Plain, MA 02130
Phone (617) 983-7000

399 Revolution Dr
Somerville, MA 02145
Phone (800) 856-1983

378 Page St
Ste 6
Stoughton, MA 02072
Phone (339) 364-8080

Interoperability endpoints

  • Direct secure messaging: phelps.lisa.bwh@direct.partners.masshiway.net

Organizations & group practices 4

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": "1515456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515456000000",
    "number": "1285141523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 STATION CIR",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020264585",
            "telephone_number": "339-225-1648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1153 CENTRE ST STE 5J",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021303446",
            "telephone_number": "617-983-7383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "LISA",
        "middle_name": "RENE'",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-09",
        "last_updated": "2018-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "119536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica Plain, MA

Sources for this page

Verify at the official NPI Registry.