Lisa Tyer Kwasinski, LCSW
Individual provider Active NPI Clinical Social Worker · Tupelo, MS
NPI 1467543785 · NPPES record last updated Nov 7, 2024
Key facts
- NPI
- 1467543785
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- C6977 (MS)
- Practice address
- Lifecore Health Group
2434 South Eason Blvd
Tupelo, MS 38804-6942 - Phone
- (662) 640-4595
- Fax
- (662) 680-6416
- NPI assigned
- Sep 28, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Northeast Mental Health-Mental Retardation Commission
Practice addresses (Care Compare)
499 Gloster Creek VLG
Tupelo, MS 38801-4600
Phone (662) 844-1717
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241120001420 | MS | Practitioner - Clinical Social Worker | 8325573991 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Mental Health/Mental Retardation Commission | Current |
Accepting new patients | |
| Northeast Mental Health-Mental Retardation Commission | Current | Accepting new patients | |
| Northeast Mental Health-Mental Retardation Commission | Current |
Accepting new patients |
Locations
499 Gloster Creek Vlg
Ste A3
Tupelo, MS 38801
Phone (662) 640-4595
2434 S Eason Blvd
Tupelo, MS 38804
Phone (662) 640-4595
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C6977 | MS | Yes |
Addresses
Primary practice location
Lifecore Health Group
2434 South Eason Blvd
Tupelo, MS 38804-6942
Mailing address
822 East Bay Circle
Tupelo, MS 38801
Other providers in Tupelo, MS
- Destiny Kulovitz
- Ajay Kumar
- Parkash Kumar
- Umesh Kumar
- Amelia S Kuykendall
- L P Britt PA
- Alexis Lachney
- Sharon Lachney
- Haley Lackey
- Regina Lacking
All providers in Tupelo, MS · Clinical Social Worker in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 7, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.