Andrea Doherty Lissuzzo, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.007467 Issued in IL

Practice address

526 Keystone Ave
River Forest, IL 60305-1612

Phone

(708) 710-2650

NPI assigned

Oct 29, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Andrea Doherty Lissuzzo Other name

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

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

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.

• Mosaic Counseling and Wellness LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Oak Park, IL
  • NPI 1851065502
  Medicare reassignment NPD
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Clinical

  NPD

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

{
    "created_epoch": "1603929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634515200000",
    "number": "1699375592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "526 KEYSTONE AVE",
            "city": "RIVER FOREST",
            "state": "IL",
            "postal_code": "603051612",
            "telephone_number": "708-710-2650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "526 KEYSTONE AVE",
            "city": "RIVER FOREST",
            "state": "IL",
            "postal_code": "603051612",
            "telephone_number": "708-710-2650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISSUZZO",
        "first_name": "ANDREA",
        "middle_name": "DOHERTY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-29",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.007467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "LISSUZZO",
            "middle_name": "DOHERTY",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Wendy R. Lauter, LCPC
• Ruta Lawrence, FNP
• Clara Wonjung Lee, D.D.S.
• Robert Barry Lees, PH.D.
• Susan P Levine, MD
• Locke & Uchitelle PC
• Rodrigo Lopez-Aguilera
• Luxottica of America Inc.
• Neonila S. Lychyk, M.D.
• Lynch Dental Center

• Clinical Social Worker in River Forest, IL
• Providers in River Forest, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.