Individual provider Active NPI

Lisa Marie Loomis, LCSW

  • Clinical Social Worker
  • Cortland, NY
National Provider Identifier
1548372436
Registry record updated Aug 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
071080 Issued in NY
Practice address
17 Main St
Suite 202
Cortland, NY 13045-6606
Phone
(607) 662-0209
Fax
(607) 662-0238
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 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 071080 NY Primary

Addresses

Primary practice location

17 Main St
Suite 202
Cortland, NY 13045-6606

Mailing address

4361 Locust Ave
Homer, NY 13077-8401
Phone (607) 423-6388

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

State licenses

LicenseStateTypeSpecialty
062225NYMDPharmacist
071080NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Network of Central New York, 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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314057600000",
    "number": "1548372436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4361 LOCUST AVE",
            "city": "HOMER",
            "state": "NY",
            "postal_code": "130778401",
            "telephone_number": "607-423-6388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 MAIN ST",
            "address_2": "SUITE 202",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130456606",
            "telephone_number": "607-662-0209",
            "fax_number": "607-662-0238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOOMIS",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2011-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "071080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cortland, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2011; 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.