Individual provider Active NPI

Lisa Lavelle, L.C.S.W.

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1669688792
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
060317-1 Issued in NY
Practice address
140 W 79TH St
Suite 2a
New York, NY 10024-6421
Phone
(212) 539-6065
NPI assigned
May 15, 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 060317-1 NY Primary

Addresses

Primary practice location

140 W 79TH St
Suite 2a
New York, NY 10024-6421

Mailing address

140 W 79TH St
Suite 2a
New York, NY 10024-6421
Phone (212) 539-6065

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
072374NYMDSocial Worker
060317-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669688792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 W 79TH ST",
            "address_2": "SUITE 2A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100246421",
            "telephone_number": "212-539-6065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 W 79TH ST",
            "address_2": "SUITE 2A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100246421",
            "telephone_number": "212-539-6065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVELLE",
        "first_name": "LISA",
        "name_prefix": "Mr.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "060317-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.