Individual provider Active NPI

Lissa Ann Grossman, LCSW

  • Mental Health Counselor
  • Norwalk, CT
National Provider Identifier
1548858848
Registry record updated Jan 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
075300-01 Issued in NY
Practice address
77 Sunrise Hill Rd
Norwalk, CT 06851-2113
Phone
(917) 658-9589
NPI assigned
Jan 4, 2021
Last updated
Jan 4, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2021

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) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 17214 NY
Mental Health Counselor 101YM0800X 075300-01 NY Primary

Addresses

Primary practice location

77 Sunrise Hill Rd
Norwalk, CT 06851-2113

Mailing address

77 Sunrise Hill Rd
Norwalk, CT 06851-2113
Phone (917) 658-9589

Other identifiers 1

IdentifierTypeStateIssuer
22553412MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20230413002276 CT Practitioner - Clinical Social Worker 3274908793 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Step Up Care PC LLCGroup PAC ID 5496088346, 176 clinicians

Practice addresses (Care Compare)

77 S Canaan Rd
Canaan, CT 06018-2517
Phone (718) 298-4375

Merit-based Incentive Payment System (MIPS)

Final score
87.14 of 100Reported as group
Quality
71.85
Improvement activities
40
Cost
75.41

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17214NYMDAddiction (Substance Use Disorder) Counselor
075300-01NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Step Up Care PC LLC Multi-Specialty CurrentSince Apr 1, 2023 Accepting new patients

Locations

27 Randolph Rd
#A
Howell, NJ 07731
Phone (732) 797-9290

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1609718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609718400000",
    "number": "1548858848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 SUNRISE HILL RD",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068512113",
            "telephone_number": "917-658-9589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 SUNRISE HILL RD",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068512113",
            "telephone_number": "917-658-9589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "LISSA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-04",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "17214",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "075300-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "22553412",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

Verify at the official NPI Registry.