Individual provider Active NPI

Lisa Frances Raia, LCSW-R

  • Clinical Social Worker
  • Smithtown, NY
National Provider Identifier
1285708321
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
075024-1 Issued in NY
Practice address
269 E Main St
Suite F2
Smithtown, NY 11787-2832
Phone
(631) 360-6695
NPI assigned
Nov 20, 2006
Last updated
Jul 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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 075024-1 NY Primary

Addresses

Primary practice location

269 E Main St
Suite F2
Smithtown, NY 11787-2832

Mailing address

PO Box 286
Smithtown, NY 11787-0286
Phone (631) 360-6695

Other identifiers 1

IdentifierTypeStateIssuer
6020754230MedicaidNY

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
I20041022000175 NY Practitioner - Clinical Social Worker 1759342884 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1212 Route 25a
Suite 3B
Stony Brook, NY 11790-1919
Phone (631) 360-6695

PO Box
Suite 286
Smithtown, NY 11787

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
075024-1NYMDClinical Social Worker
045957NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bridge Counseling Center Inc Clinical CurrentSince May 22, 2006 Accepting new patients

Locations

269 E Main St
Ste F2
Smithtown, NY 11787
Phone (631) 360-6695

1212 Route 25A
Ste 3B
Stony Brook, NY 11790
Phone (203) 650-1728

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1285708321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 286",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117870286",
            "telephone_number": "631-360-6695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "269 E MAIN ST",
            "address_2": "SUITE F2",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872832",
            "telephone_number": "631-360-6695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAIA",
        "first_name": "LISA",
        "middle_name": "FRANCES",
        "name_prefix": "Ms.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "075024-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6020754230",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.