Active NPI
Lisa Whiteman, SOCIAL WORKER
- School Social Worker
- Port Jervis, NY
National Provider Identifier
1619245065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Social Worker
- License
- R043872-1
- Practice address
- 10 Route 209
Port Jervis, NY 12771-3920 - Phone
- (845) 858-3100
- Fax
- (845) 858-2894
- NPI assigned
- Dec 13, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Social Worker | 1041S0200X | R043872-1 | NY | Primary |
Addresses
Primary practice location
10 Route 209
Port Jervis, NY 12771-3920
Mailing address
10 Route 209
Port Jervis, NY 12771-3920
Phone (845) 858-3100
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
| License | State | Type | Specialty |
|---|---|---|---|
| R043872-1 | NY | MD | School Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323734400000",
"number": "1619245065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 ROUTE 209",
"city": "PORT JERVIS",
"state": "NY",
"postal_code": "127713920",
"telephone_number": "845-858-3100",
"fax_number": "845-858-2894"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 ROUTE 209",
"city": "PORT JERVIS",
"state": "NY",
"postal_code": "127713920",
"telephone_number": "845-858-3100",
"fax_number": "845-858-2894"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITEMAN",
"first_name": "LISA",
"credential": "SOCIAL WORKER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-12-13",
"last_updated": "2011-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": "NY",
"license": "R043872-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Jervis, NY
- Westchester County Health Care Corporation (Port Jervis Community Hospital, a member of WMCHealth)
- Westchester County Health Care Corporation (Port Jervis Community Hospital, a member of WMCHealth)
- Westchester County Health Care Corporation (WMCHealth - St Joseph's)
- Amanda E Westfall, LCSW
- Whitney Rebecca White, DMD
- Michael Jason Wickham, LCSW
- Robert Wilkins, M.D.
- William B Horn DDS PC (Aesthetic Family Dentistry)
- Clarise Denise Williams
- Annette Wilson, CASAC-T
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.