Individual provider Active NPI

Lisa Perrone, LICSW

  • Clinical Social Worker
  • Dorchester, MA
National Provider Identifier
1407136377
Registry record updated Aug 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
113356 Issued in MA
Practice address
500 Columbia Rd
Mailstop 415-05
Dorchester, MA 02125-2322
Phone
(617) 740-8138
Fax
(617) 282-7603
NPI assigned
Aug 24, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2011

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 113356 MA Primary

Addresses

Primary practice location

500 Columbia Rd
Mailstop 415-05
Dorchester, MA 02125-2322

Mailing address

500 Columbia Rd
Mailstop 415-05
Dorchester, MA 02125-2322
Phone (617) 740-8138

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20120419000640 MA Order and Referring Only - Clinical Social Worker 9830350784

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
113356MAMDClinical Social Worker

Interoperability endpoints

  • Direct secure messaging: lperrone180221@direct.ochin.org

NPI Registry JSON

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

{
    "created_epoch": "1314144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314144000000",
    "number": "1407136377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 COLUMBIA RD",
            "address_2": "MAILSTOP 415-05",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021252322",
            "telephone_number": "617-740-8138",
            "fax_number": "617-282-7603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 COLUMBIA RD",
            "address_2": "MAILSTOP 415-05",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021252322",
            "telephone_number": "617-740-8138",
            "fax_number": "617-282-7603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRONE",
        "first_name": "LISA",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-24",
        "last_updated": "2011-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "113356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorchester, MA

Sources for this page

Verify at the official NPI Registry.