Lisa Anne Cornelius, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC50079681 Issued in DC

Practice address

8609 Sudley Rd
Suite 201
Manassas, VA 20110-8321

Phone

(571) 334-0752

Fax

(703) 530-8801

NPI assigned

May 6, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Evergreen Counseling and Psychological Associates LLCGroup PAC ID 3577780782, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Evergreen Counseling and Psychological Associates LLC

  • Professional Counselor
  • Philadelphia, PA
  • NPI 1053748939

  Clinical

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1462492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467158400000",
    "number": "1306292552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8609 SUDLEY RD",
            "address_2": "SUITE 201",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201108321",
            "telephone_number": "571-334-0752",
            "fax_number": "703-530-8801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8609 SUDLEY RD",
            "address_2": "SUITE 201",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201108321",
            "telephone_number": "571-334-0752",
            "fax_number": "703-530-8801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNELIUS",
        "first_name": "LISA",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-06",
        "last_updated": "2016-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC50079681",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904009525",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judy Gentry Corcoran, C.F.N.P.
• Igryl S. Cordero-Hernandez, M.D.
• Corecare Behavorial Services LLC
• Corecomfort Medical Supplies LLC
• Francisco Javier Cornejo
• Helen Christine Coronel, A.R.N.P.
• Amy Corrales
• Jacqueline Joanne Corry, DPT
• Melanie Corum
• Keller Cosimano, LCSW

• Clinical Social Worker in Manassas, VA
• Providers in Manassas, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2016; 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.