Active NPI
Lori Lee Widener, LCSW
- Clinical Social Worker
- Philadelphia, PA
National Provider Identifier
1619431301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CW019299
- Practice address
- 329 Lyceum Ave
Philadelphia, PA 19128-4815 - Phone
- (503) 944-9353
- NPI assigned
- Jan 26, 2019
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CW019299 | PA | Primary |
Addresses
Primary practice location
329 Lyceum Ave
Philadelphia, PA 19128-4815
Mailing address
329 Lyceum Ave
Philadelphia, PA 19128-4815
Phone (503) 944-9353
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 |
|---|---|---|---|
| CW019299 | PA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548460800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548460800000",
"number": "1619431301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "329 LYCEUM AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191284815",
"telephone_number": "503-944-9353"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "329 LYCEUM AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191284815",
"telephone_number": "503-944-9353"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIDENER",
"first_name": "LORI",
"middle_name": "LEE",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-26",
"last_updated": "2019-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": "PA",
"license": "CW019299",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.