Individual provider Active NPI

Lisa McDermott, CSW

  • Clinical Social Worker
  • Syracuse, NY
National Provider Identifier
1396829297
Registry record updated Dec 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R039562-1 Issued in NY
Practice address
600 E Genesee St
217
Syracuse, NY 13202-3130
Phone
(315) 422-0300
Fax
(315) 479-8455
NPI assigned
Oct 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R039562-1 NY Primary

Addresses

Primary practice location

600 E Genesee St
217
Syracuse, NY 13202-3130

Mailing address

600 E Genesee St
217
Syracuse, NY 13202-3130
Phone (315) 422-0300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20111019000891 NY Practitioner - Clinical Social Worker 7719159524 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3300 James St
Suite 100
Syracuse, NY 13206-2392
Phone (315) 422-0300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological Healthcare, PLLC CurrentSince Aug 13, 2001 Accepting new patients
Psychiatry Services of New York, P.C. Clinical CurrentSince Feb 20, 2024 Accepting new patients
Psychiatry Services of New York PC CurrentSince Feb 20, 2024 Accepting new patients

Locations

8289 Loop Rd
Baldwinsville, NY 13027
Phone (315) 452-0300

3300 James St
Ste 201
Syracuse, NY 13206
Phone (315) 437-4500

3300 James St
Ste 100
Syracuse, NY 13206

3300 James St
Ste 101
Syracuse, NY 13206

600 E Genesee St
Ste 217
Syracuse, NY 13202
Phone (315) 452-0300

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/28623/brand/6/csg/1/fhir/r4

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292803200000",
    "number": "1396829297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 E GENESEE ST",
            "address_2": "217",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132023130",
            "telephone_number": "315-422-0300",
            "fax_number": "315-479-8455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E GENESEE ST",
            "address_2": "217",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132023130",
            "telephone_number": "315-422-0300",
            "fax_number": "315-479-8455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDERMOTT",
        "first_name": "LISA",
        "credential": "CSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2010-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R039562-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.