Individual provider Active NPI

Lisa Kirk, LCSW

  • Clinical Social Worker
  • Pomona, NY
National Provider Identifier
1639210776
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
33151 Issued in NY
Practice address
50 Sanitorium Rd
BLDG F
Pomona, NY 10970-3555
Phone
(845) 364-2275
NPI assigned
Feb 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 33151 NY Primary

Addresses

Primary practice location

50 Sanitorium Rd
BLDG F
Pomona, NY 10970-3555

Mailing address

11 Ackerman Ave
Airmont, NY 10901-7119
Phone (845) 357-2084

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

LicenseStateTypeSpecialty
33151NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1171065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639210776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 ACKERMAN AVE",
            "city": "AIRMONT",
            "state": "NY",
            "postal_code": "109017119",
            "telephone_number": "845-357-2084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 SANITORIUM RD",
            "address_2": "BLDG F",
            "city": "POMONA",
            "state": "NY",
            "postal_code": "109703555",
            "telephone_number": "845-364-2275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "LISA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "33151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.