Individual provider Active NPI

Lisa Demario, LCSW, LCADC

  • Clinical Social Worker
  • Northfield, NJ
National Provider Identifier
1518407501
Registry record updated Sep 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05709600 Issued in NJ
Practice address
450 Tilton Rd
Northfield, NJ 08225-1256
Phone
(609) 515-2838
NPI assigned
Feb 24, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 37LC00174300 NJ
Clinical Social Worker 1041C0700X 44SC05709600 NJ Primary

Addresses

Primary practice location

450 Tilton Rd
Northfield, NJ 08225-1256

Mailing address

175 W Cohawkin Rd Ste C
Clarksboro, NJ 08020-1145
Phone (856) 423-7700

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
37LC00174300NJMDAddiction (Substance Use Disorder) Counselor
44SC05709600NJMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1487894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568851200000",
    "number": "1518407501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 W COHAWKIN RD STE C",
            "city": "CLARKSBORO",
            "state": "NJ",
            "postal_code": "080201145",
            "telephone_number": "856-423-7700",
            "fax_number": "856-423-0823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 TILTON RD",
            "city": "NORTHFIELD",
            "state": "NJ",
            "postal_code": "082251256",
            "telephone_number": "609-515-2838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMARIO",
        "first_name": "LISA",
        "name_prefix": "Ms.",
        "credential": "LCSW, LCADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-24",
        "last_updated": "2019-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00174300",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05709600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northfield, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.