Individual provider Active NPI

Lisa Sarkees Dacko

  • Clinical Social Worker
  • Fort Sam Houston, TX
National Provider Identifier
1669948261
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW13972 Issued in FL
Practice address
3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504
Phone
(210) 916-7500
NPI assigned
Oct 22, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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 SW13972 FL Primary

Addresses

Primary practice location

3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504

Mailing address

3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504
Phone (210) 916-7500

Other practice location 1

7901 4th St N # 25524
St Petersburg, FL 33702-4305
Phone (321) 501-1770

Other identifiers 1

IdentifierTypeStateIssuer
106729300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181228001793 FL Practitioner - Clinical Social Worker 8628313244

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1003 Alabaster CV
Sanford, FL 32771-3607

PO Box
Suite 1137
Melbourne, FL 32902

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW13972FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Brevard Health Alliance Inc Current Accepting new patients
Brevard Health Alliance, Inc. CurrentSince Dec 30, 2023 Accepting new patients
Calm Waters Collective LLC Clinical CurrentSince Mar 20, 2025 Accepting new patients
Teladoc Health Medical Group, P.a. Clinical Current Accepting new patients
Brevard Health Alliance Inc CurrentSince Dec 30, 2023 Accepting new patients
Blue Moon Senior Counseling Clinical CurrentSince Nov 8, 2018 Accepting new patients

Locations

2120 Sarno Rd
Melbourne, FL 32935
Phone (321) 952-9696

220 Barton Blvd
Unit C14
Rockledge, FL 32955
Phone (321) 639-5177

10204 Bode St
Ste B
Plainfield, IL 60585
Phone (630) 229-6462

Interoperability endpoints

  • Direct secure messaging: lisasarkees@tdh.allscriptsdirect.net

Organizations & group practices 6

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": "1540166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1669948261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-7500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7901 4th St N # 25524",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337024305",
            "country_code": "US",
            "telephone_number": "321-501-1770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DACKO",
        "first_name": "LISA",
        "middle_name": "SARKEES",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-22",
        "last_updated": "2025-06-02",
        "certification_date": "2025-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW13972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106729300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Sam Houston, TX

Sources for this page

Verify at the official NPI Registry.