Lisa Ann Traver-Etheridge, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

003683 Issued in FL

Practice address

7857 Reynolds CT
Tallahassee, FL 32312-9050

Phone

(850) 583-0335

Fax

(850) 583-0335

NPI assigned

Jan 30, 2009

Last updated

Jun 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Senior Living Behavioral Health LCSW PLLC

  • Clinical Social Worker
  • New York, NY
  • NPI 1083150056
  NPD (past)

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

{
    "created_epoch": "1233273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1346488277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7857 REYNOLDS CT",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323129050",
            "telephone_number": "850-583-0335",
            "fax_number": "850-583-0335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7857 REYNOLDS CT",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323129050",
            "telephone_number": "850-583-0335",
            "fax_number": "850-583-0335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVER-ETHERIDGE",
        "first_name": "LISA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-30",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "003683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.