Individual provider Active NPI

Lisa Fallara, LISW-S

  • Clinical Social Worker
  • Columbus, OH
National Provider Identifier
1558762799
Registry record updated Feb 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.0800161 Issued in OH
Practice address
3763 N High St
Columbus, OH 43214-3547
Phone
(614) 257-8442
NPI assigned
Sep 8, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2015

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 I.0800161 OH Primary

Addresses

Primary practice location

3763 N High St
Columbus, OH 43214-3547

Mailing address

3763 N High St
Columbus, OH 43214-4056
Phone (614) 257-8442

Other identifiers 1

IdentifierTypeStateIssuer
I.0800161OtherOHOHIO SOCIAL WORK AND COUNSELOR BOARD

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
I.0800161OHMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1410134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424736000000",
    "number": "1558762799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3763 N HIGH ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432144056",
            "telephone_number": "614-257-8442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3763 N HIGH ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432143547",
            "telephone_number": "614-257-8442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALLARA",
        "first_name": "LISA",
        "credential": "LISW-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-08",
        "last_updated": "2015-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.0800161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO SOCIAL WORK AND COUNSELOR BOARD",
            "identifier": "I.0800161",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2015; 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.