Active NPI
Lisa C Buonomano, LCSW
- Clinical Social Worker
- Blacksburg, VA
National Provider Identifier
1629465711
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904008854
- Practice address
- 700 University City Blvd
Blacksburg, VA 24060-2706 - Phone
- (540) 961-8300
- Fax
- (540) 961-8465
- NPI assigned
- Apr 16, 2015
- Sex
- Female
- Sole proprietor
- No
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 | 0904008854 | VA | Primary |
Addresses
Primary practice location
700 University City Blvd
Blacksburg, VA 24060-2706
Mailing address
700 University City Blvd
Blacksburg, VA 24060-2706
Phone (540) 961-8300
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0904008854 | VA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429142400000",
"number": "1629465711",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 UNIVERSITY CITY BLVD",
"city": "BLACKSBURG",
"state": "VA",
"postal_code": "240602706",
"telephone_number": "540-961-8300",
"fax_number": "540-961-8465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 UNIVERSITY CITY BLVD",
"city": "BLACKSBURG",
"state": "VA",
"postal_code": "240602706",
"telephone_number": "540-961-8300",
"fax_number": "540-961-8465"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUONOMANO",
"first_name": "LISA",
"middle_name": "C",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-16",
"last_updated": "2015-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904008854",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blacksburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.