Active NPI
Lisa B Sedjat, LCSW
- Clinical Social Worker
- Virginia Beach, VA
National Provider Identifier
1407161565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904002771
- Practice address
- 2108 Thoroughgood Rd
Virginia Beach, VA 23455-4015 - Phone
- (757) 416-5325
- Fax
- (757) 416-5326
- NPI assigned
- Aug 13, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 0904002771 | VA | Primary |
Addresses
Primary practice location
2108 Thoroughgood Rd
Virginia Beach, VA 23455-4015
Mailing address
2108 Thoroughgood Rd
Virginia Beach, VA 23455-4015
Phone (757) 416-5325
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902839277 | Medicaid | VA | |
| 0152882137 | Medicaid | VA | |
| 0102994115 | Medicaid | VA | |
| 0101569637 | Medicaid | VA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Behavioral Interventions, Training & Evaluations, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Specialist
- Virginia Beach, VA
- NPI 1902839277
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1281657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281657600000",
"number": "1407161565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2108 THOROUGHGOOD RD",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234554015",
"telephone_number": "757-416-5325",
"fax_number": "757-416-5326"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2108 THOROUGHGOOD RD",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234554015",
"telephone_number": "757-416-5325",
"fax_number": "757-416-5326"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEDJAT",
"first_name": "LISA",
"middle_name": "B",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-08-13",
"last_updated": "2010-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904002771",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1902839277",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0152882137",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0102994115",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0101569637",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.