Individual provider Active NPI

Lisa Goodman Niederman, LCSW

  • Clinical Social Worker
  • Gastonia, NC
National Provider Identifier
1568470367
Registry record updated Sep 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C009243 Issued in NC
Practice address
1337 E Garrison Blvd
Gastonia, NC 28054-5127
Phone
(704) 834-2000
Fax
(704) 854-3086
NPI assigned
Aug 4, 2006
Last updated
Sep 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X ISW00498 RI
Clinical Social Worker 1041C0700X C009243 NC Primary

Addresses

Primary practice location

1337 E Garrison Blvd
Gastonia, NC 28054-5127

Mailing address

1337 E Garrison Blvd
Gastonia, NC 28054-5127

Other identifiers 4

IdentifierTypeStateIssuer
62-67493OtherRIUBH
408503OtherRIBLUE CHIP
LY10977MedicaidRI
30118-1OtherRIBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20210412001421 NC Practitioner - Clinical Social Worker 5597747659 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Erickson Health Medical Group of North Carolina, PCGroup PAC ID 6406104165, 5 clinicians

Practice addresses (Care Compare)

2030 Windsor Run LN
Matthews, NC 28105-0054
Phone (704) 443-6250

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ISW00498RIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Clinical Current Accepting new patients
Caromont Medical Group Inc Current Accepting new patients
Erickson Health Medical Group of North Carolina, PC CurrentSince Mar 10, 2025 Accepting new patients
Caromont Medical Group Inc CurrentSince May 6, 2024 Accepting new patients
Caromont Medical Group Inc CurrentSince May 6, 2024 Accepting new patients
Christine Richards LLC PastSince Jul 1, 2021 Accepting new patients
One Medical, P.C. Past Accepting new patients

Locations

5730 Executive Dr
Ste 230
Catonsville, MD 21228
Phone (410) 402-2379

1337 E Garrison Blvd
Gastonia, NC 28054
Phone (704) 671-5313

2525 Court Dr
Gastonia, NC 28054
Phone (704) 834-2662

2030 Windsor Run Ln
Matthews, NC 28105
Phone (704) 432-6250

Interoperability endpoints

  • Direct secure messaging: lisayanku@tdh.allscriptsdirect.net

Organizations & group practices 7

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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789948800000",
    "number": "1568470367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1337 E GARRISON BLVD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280545127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1337 E GARRISON BLVD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280545127",
            "telephone_number": "704-834-2000",
            "fax_number": "704-854-3086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEDERMAN",
        "first_name": "LISA",
        "middle_name": "GOODMAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW00498",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C009243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH",
            "identifier": "62-67493",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "408503",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LY10977",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "30118-1",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.