Lisa Marie Connolly, LICSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

213222 Issued in MA

Practice address

69 Alleghany St
Roxbury Crossing, MA 02120-3336

Phone

(617) 524-4620

Fax

(617) 983-1658

NPI assigned

Mar 9, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Riverside Community Care, Inc.

  • Community/Behavioral Health Agency
  • Norwood, MA
  • NPI 1780791467
  NPD

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300838400000",
    "number": "1619009560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 ALLEGHANY ST",
            "city": "ROXBURY CROSSING",
            "state": "MA",
            "postal_code": "021203336",
            "telephone_number": "617-524-4620",
            "fax_number": "617-983-1658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 ALLEGHANY ST",
            "city": "ROXBURY CROSSING",
            "state": "MA",
            "postal_code": "021203336",
            "telephone_number": "617-524-4620",
            "fax_number": "617-983-1658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2011-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": "213222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chima Ohaegbulam, MD PC
• Cheryl Renee Clark, MD, M.S., SD
• Yvette Colon, O.D
• Commonwealth Land Trust, Inc.
• Commonwealth Land Trust, Inc.
• Elise Adele Counsell
• Roberto Antonio Cruz-Gervis, MD
• Brenda Louise Daley, LICSW
• David H Kim, MD PC
• Susan Davidson, M.D.

• Social Worker in Roxbury Crossing, MA
• Providers in Roxbury Crossing, MA by specialty
• Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.