Individual provider Active NPI

Lisa Celiberti, L.C.S.W.

  • Social Worker
  • East Setauket, NY
National Provider Identifier
1659419984
Registry record updated Jun 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
R0402151NY Issued in NY
Practice address
377 Pond Path
East Setauket, NY 11733-1020
Phone
(631) 338-0708
Fax
(631) 689-2007
NPI assigned
Feb 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X R0402151NY NY Primary

Addresses

Primary practice location

377 Pond Path
East Setauket, NY 11733-1020

Mailing address

377 Pond Path
Setauket, NY 11733-1020
Phone (631) 338-0708

Other identifiers 8

IdentifierTypeStateIssuer
60054OtherNYAETNA
SX173OtherNYVALUE OPTIONS
P3086836OtherNYOXFORD
SB803OtherNYBCBS
11303OtherNYMAGNACARE
87726OtherNYUNITED HEALTH CARE
138975OtherNYVALUE OPTIONS
N403K1OtherNYEMPIRE BC/BS

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

LicenseStateTypeSpecialty
R0402151NYNYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Setauket Licensed Clinical Social Work Consultation Services PLLC Past Accepting new patients
Paul J Botticelli LCSW PC PastSince Nov 1, 2020 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593129600000",
    "number": "1659419984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "377 POND PATH",
            "city": "SETAUKET",
            "state": "NY",
            "postal_code": "117331020",
            "telephone_number": "631-338-0708",
            "fax_number": "631-689-2007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "377 POND PATH",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117331020",
            "telephone_number": "631-338-0708",
            "fax_number": "631-689-2007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CELIBERTI",
        "first_name": "LISA",
        "name_prefix": "Ms.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2020-06-26",
        "certification_date": "2020-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "R0402151NY",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "60054",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "SX173",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P3086836",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "SB803",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGNACARE",
            "identifier": "11303",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "87726",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "138975",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BC/BS",
            "identifier": "N403K1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2020; 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.