Individual provider Active NPI

Lisa Ann Parsons, LCSW

  • Clinical Social Worker
  • Gulfport, MS
National Provider Identifier
1356687396
Registry record updated Mar 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C9311 Issued in MS
Practice address
240B Courthouse Rd
Gulfport, MS 39507-1214
Phone
(228) 865-1330
NPI assigned
Dec 19, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2023

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 4520 KS
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X C9311 MS Primary

Addresses

Primary practice location

240B Courthouse Rd
Gulfport, MS 39507-1214

Mailing address

4013 Beatline Rd Ste a
Long Beach, MS 39560-4135
Phone (228) 700-0720

Other practice location 1

4011 Beatline Rd # 14C
Long Beach, MS 39560-4137
Phone (228) 200-0720

Other identifiers 1

IdentifierTypeStateIssuer
06833775MedicaidMS

Other names 1

  • Lisa Ann Nelson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, MS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160219000197 KS Practitioner - Clinical Social Worker 2264737873 Reassigns benefits to 1 organization
I20190626001763 MS Practitioner - Clinical Social Worker 2264737873 Reassigns benefits to 2 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

Practice addresses (Care Compare)

240 Courthouse Rd
Suite B
Gulfport, MS 39507-1214
Phone (228) 343-3432

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4520KSMDClinical Social Worker
C9311MSMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pawnee Mental Health Service, Inc. CurrentSince Jan 14, 2016 Accepting new patients
Pawnee Mental Health Service, Inc. Single Specialty CurrentSince Jan 14, 2016 Accepting new patients
Insights Christian Counseling Clinical CurrentSince Jan 1, 2023 Accepting new patients
Safe Harbor Clinic LLC Single Specialty CurrentSince Mar 15, 2019 Accepting new patients

Locations

814 Caroline Ave
Junction City, KS 66441
Phone (785) 762-5250

2001 Claflin Rd
Manhattan, KS 66502

240B Courthouse Rd
Gulfport, MS 39507
Phone (228) 343-3432

240 Courthouse Rd
#B
Gulfport, MS 39507
Phone (228) 343-3432

4013 Beatline Rd
#A
Long Beach, MS 39560
Phone (228) 200-0720

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": "1355875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1356687396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4013 BEATLINE RD STE A",
            "city": "LONG BEACH",
            "state": "MS",
            "postal_code": "395604135",
            "telephone_number": "228-700-0720",
            "fax_number": "228-200-0383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240B COURTHOUSE RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395071214",
            "telephone_number": "228-865-1330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4011 Beatline Rd # 14C",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "MS",
            "postal_code": "395604137",
            "country_code": "US",
            "telephone_number": "228-200-0720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARSONS",
        "first_name": "LISA",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-19",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "4520",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C9311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06833775",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "NELSON",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.