Individual provider Active NPI

Lisette Sanchez, LCSW

  • Clinical Social Worker
  • Philadelphia, PA
National Provider Identifier
1326660705
Registry record updated Sep 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW022079 Issued in PA
Practice address
3905 Ford Rd Ste 6
Philadelphia, PA 19131-2824
Phone
(215) 878-3400
NPI assigned
May 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CW022079 PA Primary
Social Worker 104100000X SW132954 PA

Addresses

Primary practice location

3905 Ford Rd Ste 6
Philadelphia, PA 19131-2824

Mailing address

3905 Ford Rd Ste 6
Philadelphia, PA 19131-2824
Phone (215) 878-3400

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20211203002385 PA Practitioner - Clinical Social Worker 9335539444 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW132954PAMDSocial Worker
CW022079PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC CurrentSince Dec 20, 2021 Accepting new patients
Vitae Health Medical Pennsylvania LLC Clinical CurrentSince Sep 18, 2021 Accepting new patients
Grow Healthcare Group PA Clinical CurrentSince Nov 30, 2022 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

415 W Golf Rd
Ste 26
Arlington Hts, IL 60005

303 E Wacker Dr
Ste 1127
Chicago, IL 60601
Phone (312) 328-2347

7800 Bustleton Ave
Philadelphia, PA 19152
Phone (215) 722-2300

1626 Locust St
Philadelphia, PA 19103
Phone (215) 709-3177

1015 Chestnut St
Ste 1520
Philadelphia, PA 19107
Phone (215) 601-7379

Organizations & group practices 3

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": "1588896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1326660705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3905 FORD RD STE 6",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191312824",
            "telephone_number": "215-878-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3905 FORD RD STE 6",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191312824",
            "telephone_number": "215-878-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANCHEZ",
        "first_name": "LISETTE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-08",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW022079",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW132954",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.