Lisa Staab, LCSW, LISW-CP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

12048 Issued in WI

Practice address

671 Jamestown Dr Unit 102
Murrells Inlet, SC 29576-7511

Phone

(316) 680-4794

Fax

(316) 680-4794

NPI assigned

Aug 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 4

Addresses

Medicare fee-for-service enrollment

Enrolled in SC, CO, VA, LA, NC, AR, WI7 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 7

Specialty

Clinical Social Worker

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lisastaab@tdh.allscriptsdirect.net

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.

• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  AR, LA, SC, VA

  Medicare reassignment Care Compare group
• Azalea Health Services

  • Clinical Social Worker
  • Lafayette, LA
  • NPI 1043999170
  Medicare reassignment NPD
• Sondermind PC

  • Clinical Social Worker
  • San Jose, CA
  • NPI 1003646977

  NC

  Medicare reassignment NPD
• Azalea Health Services Texas LLC

  • Clinical Social Worker
  • New Braunfels, TX
  • NPI 1326871807
  NPD
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Clinical

  NPD

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

{
    "created_epoch": "1470441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1396299442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1492",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295761492",
            "telephone_number": "316-680-4794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "671 JAMESTOWN DR UNIT 102",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295767511",
            "telephone_number": "316-680-4794",
            "fax_number": "316-680-4794"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 N West Ave",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MI",
            "postal_code": "492022179",
            "country_code": "US",
            "telephone_number": "517-789-1200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAAB",
        "first_name": "LISA",
        "credential": "LCSW, LISW-CP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-06",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "09924360",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "11774",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801117714",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "12048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southern Urgent Care Murrell's Inlet LLC
• Southerncare, Inc. (SouthernCare Myrtle Beach)
• Anna Elizabeth Speer, DPT
• Steven Paul Sponaugle, FNP-C
• Jessica Spring, FNP-C
• Brittany Stancil, NURSE PRACTITIONER
• Miranda Starlyn, RDN
• Sthomasinc
• Angela Pace Stiles, FNP
• Robert Allen Stinson Jr., D.C.

• Clinical Social Worker in Murrells Inlet, SC
• Providers in Murrells Inlet, SC by specialty
• Clinical Social Worker in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; 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.