Individual provider Active NPI

Lisa Dillard, LCSW

  • Clinical Social Worker
  • Jenkintown, PA
National Provider Identifier
1588310973
Registry record updated Feb 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CCW021393 Issued in PA
Practice address
610 Old York Rd
Suite 220
Jenkintown, PA 19046-0361
Phone
(215) 376-6200
Fax
(215) 376-6191
NPI assigned
Feb 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2022

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 CCW021393 PA Primary

Addresses

Primary practice location

610 Old York Rd
Suite 220
Jenkintown, PA 19046-0361

Mailing address

610 Old York Rd
Suite 220
Jenkintown, PA 19046-0361
Phone (215) 376-6200

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
CCW021393PAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1645660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1588310973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 OLD YORK RD",
            "address_2": "SUITE 220",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190460361",
            "telephone_number": "215-376-6200",
            "fax_number": "215-376-6191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 OLD YORK RD",
            "address_2": "SUITE 220",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190460361",
            "telephone_number": "215-376-6200",
            "fax_number": "215-376-6191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLARD",
        "first_name": "LISA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-24",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CCW021393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jenkintown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; 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.